TY - JOUR
T1 - Long-term oncologic and functional outcomes after robot-assisted partial nephrectomy in elderly patients
AU - Vartolomei, Mihai D.
AU - Matei, Deliu V.
AU - Renne, Giuseppe
AU - Tringali, Valeria M.
AU - Crișan, Nicolae
AU - Musi, Gennaro
AU - Mistretta, Francesco A.
AU - Russo, Andrea
AU - Conti, Andrea
AU - Cozzi, Gabriele
AU - Luzzago, Stefano
AU - Catellani, Michele
AU - Cioffi, Antonio
AU - Cordima, Giovanni
AU - Bianchi, Roberto
AU - Di Trapani, Ettore
AU - Serino, Alessandro
AU - Delor, Maurizio
AU - Bianco, Raffaele
AU - Bottero, Danilo
AU - Ferro, Matteo
AU - de Cobelli, Ottavio
PY - 2019/2
Y1 - 2019/2
N2 - BACKGROUND: The aim of this study was to assess the long-term oncologic and functional outcomes in elderly patients having undergone robot-assisted partial nephrectomy (RAPN) for renal cancer (RC). METHODS: Sixty-one patients out of 323 who underwent RAPN for localized RC between July 2009 and March 2016 in our high-volume robotic surgery center (>800 procedures/year), had 70 years or more. Inclusion criteria of the study were age ≥70 years; pathological confirmed RCC and ASA Score ≤3. All patients were stratified according to PADUA classification system in three groups: <7 points, 8-9 points, >10 points. Trifecta was defined as a warm ischemia time (WIT) less then 25 min, negative surgical margins and no perioperative complications. RESULTS: A total of 52 patients were included; median follow-up was 47 months. Median age was 74 yrs. (IQR 72-76.5). Complication rate was 15.4%. Trifecta failure was associated to PADUA Score (P=0.02), and tumor diameter (P=0.04). Renal function was altered in 10 (19.2%) patients before surgery and at last follow-up in 11 (21.1%) patients (CKD stage>2) The DFS, OS and CSS were 89.33%, 90.06% and 94.4%, respectively. CONCLUSIONS: In a high-volume center, robot-assisted approach is feasible and safe in surgical fit elderly patients with good long-term oncologic outcomes.
AB - BACKGROUND: The aim of this study was to assess the long-term oncologic and functional outcomes in elderly patients having undergone robot-assisted partial nephrectomy (RAPN) for renal cancer (RC). METHODS: Sixty-one patients out of 323 who underwent RAPN for localized RC between July 2009 and March 2016 in our high-volume robotic surgery center (>800 procedures/year), had 70 years or more. Inclusion criteria of the study were age ≥70 years; pathological confirmed RCC and ASA Score ≤3. All patients were stratified according to PADUA classification system in three groups: <7 points, 8-9 points, >10 points. Trifecta was defined as a warm ischemia time (WIT) less then 25 min, negative surgical margins and no perioperative complications. RESULTS: A total of 52 patients were included; median follow-up was 47 months. Median age was 74 yrs. (IQR 72-76.5). Complication rate was 15.4%. Trifecta failure was associated to PADUA Score (P=0.02), and tumor diameter (P=0.04). Renal function was altered in 10 (19.2%) patients before surgery and at last follow-up in 11 (21.1%) patients (CKD stage>2) The DFS, OS and CSS were 89.33%, 90.06% and 94.4%, respectively. CONCLUSIONS: In a high-volume center, robot-assisted approach is feasible and safe in surgical fit elderly patients with good long-term oncologic outcomes.
KW - Aged-Robotic surgical procedures
KW - Carcinoma, renal cell
KW - Elderly
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U2 - 10.23736/S0393-2249.18.03006-0
DO - 10.23736/S0393-2249.18.03006-0
M3 - Article
C2 - 30230293
AN - SCOPUS:85061225023
VL - 71
SP - 31
EP - 37
JO - Minerva Urologica e Nefrologica
JF - Minerva Urologica e Nefrologica
SN - 0393-2249
IS - 1
ER -