Margin, ischemia, and complications system to report perioperative outcomes of robotic partial nephrectomy: A European multicenter observational study (EMOS project)

Giuliana Lista, Nicolò Maria Buffi, Giovanni Lughezzani, Massimo Lazzeri, Alberto Abrate, Alessandro Mistretta, Alessandro Larcher, Paolo Dell'Oglio, Nicola Fossati, James Porter, Vincenzo Ficarra, Alexander Mottrie, Giorgio Guazzoni

Research output: Contribution to journalArticlepeer-review

Abstract

Objective To explore the margin, ischemia, and complications (MIC) system achievement rate within a population of patients who were treated with robotic partial nephrectomy (RAPN), at 3 different tertiary care centers, and to determine the factors predicting MIC achievement. Methods The study population consisted of 339 patients who underwent RAPN for cT1 renal tumors at 3 centers. Cancer control was defined as the absence of positive surgical margin. Ideal threshold of warm ischemia time (WIT) was considered ≤20 minutes. Safety was defined as the absence of major complications. The achievement of MIC was considered as the fulfillment of all these 3 outcomes. The primary endpoint was to determine the MIC rate in our study population; the secondary endpoint was to detect factors affecting its achievement. Results The overall MIC rate was 67%. Median WIT was 17 minutes (range, 7-51 minutes). In 88 cases (26%), WIT was 20 minutes. Positive surgical margins were found in 22 patients (6.5%). Overall postoperative and major complication rates were 14.5% (n = 49) and 3.8% (n = 13). In multivariate logistic regression analysis, continuously coded and categorically coded preoperative aspects and dimensions used for an anatomical scores were an independent predictor of MIC achievement (odds ratio, 0.636; confidence interval, 0.436-0.928; P =.019 and odds ratio, 0.098; confidence interval, 0.030-0.326; P .001). Conclusion The MIC binary system may represent a useful tool to summarize the achievement of optimal perioperative outcomes of RAPN. In the current population, tumor complexity was significantly associated with MIC achievement.

Original languageEnglish
Pages (from-to)589-594
Number of pages6
JournalUrology
Volume85
Issue number3
DOIs
Publication statusPublished - Mar 1 2015

ASJC Scopus subject areas

  • Medicine(all)
  • Urology

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