Open versus laparoscopic partial nephrectomy for clinical T1a renal masses: A matched-pair comparison of 280 patients with TRIFECTA outcomes (RECORd Project)

Andrea Minervini, Giampaolo Siena, Alessandro Antonelli, Giampaolo Bianchi, Aldo Massimo Bocciardi, Sergio Cosciani Cunico, Vincenzo Ficarra, Cristian Fiori, Ferdinando Fusco, Andrea Mari, Giuseppe Martorana, Mauro Medica, Vincenzo Mirone, Giuseppe Morgia, Francesco Porpiglia, Francesco Rocco, Bruno Rovereto, Riccardo Schiavina, Claudio Simeone, Carlo TerroneAlessandro Volpe, Marco Carini, Sergio Serni

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Abstract

Aim of the study: To report a matched-pair comparative analysis between open (OPN) and laparoscopic partial nephrectomy (LPN) for clinical (c) T1a renal masses from a large prospective multicenter dataset. Materials and methods: The RECORd Project includes all patients who underwent OPN and LPN for kidney cancer between January 2009 and January 2011 at 19 Italian centers. Open and laparoscopic groups were compared regarding clinical, surgical, pathologic, functional results and TRIFECTA outcome. Multivariable logistic regression models were used to analyze predictors of WIT >25 min, surgical complications (SC) and the achievement of the TRIFECTA outcome. Results: Overall, 301 patients had OPN and 149 LPN. Groups were matched 1:1 (140 matched pairs) for clinical diameter, tumor location and type of indication. Laparoscopic partial nephrectomy was associated with a significantly mean longer WIT (19.9 vs. 15.1 min; p <0.001), and it was an independent predictor of a WIT >25 min (RR 6.29, p <0.0001). The TRIFECTA was achieved in 78.6 and 74.3 % after OPN and LPN (p = ns), respectively, and the surgical approach was not a predictor of a negative TRIFECTA and SC at multivariable analysis. At 6-month follow-up, no significant differences were observed between the OPN and LPN group both in estimated glomerular filtration rate (eGFR) ({increment}GFR 1.1 vs. 4.1 mL/min) and in new-onset stage III-V chronic kidney disease (CKD) rate (0 vs. 0.7 %). Conclusion: No significant difference in achieving the TRIFECTA outcome was reported after OPN and LPN. LPN was associated with a significantly longer WIT. However, eGFR at 6-month follow-up did not differ significantly between the two surgical approaches.

Original languageEnglish
Pages (from-to)257-263
Number of pages7
JournalWorld Journal of Urology
Volume32
Issue number1
DOIs
Publication statusPublished - Feb 2014

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Nephrectomy
Kidney
Glomerular Filtration Rate
Logistic Models
Matched-Pair Analysis
Kidney Neoplasms
Chronic Renal Insufficiency
Research Design
Neoplasms

Keywords

  • Kidney cancer
  • Laparoscopic partial nephrectomy
  • Laparoscopic versus open matched-pair comparison
  • Open partial nephrectomy
  • TRIFECTA

ASJC Scopus subject areas

  • Urology

Cite this

Open versus laparoscopic partial nephrectomy for clinical T1a renal masses : A matched-pair comparison of 280 patients with TRIFECTA outcomes (RECORd Project). / Minervini, Andrea; Siena, Giampaolo; Antonelli, Alessandro; Bianchi, Giampaolo; Bocciardi, Aldo Massimo; Cosciani Cunico, Sergio; Ficarra, Vincenzo; Fiori, Cristian; Fusco, Ferdinando; Mari, Andrea; Martorana, Giuseppe; Medica, Mauro; Mirone, Vincenzo; Morgia, Giuseppe; Porpiglia, Francesco; Rocco, Francesco; Rovereto, Bruno; Schiavina, Riccardo; Simeone, Claudio; Terrone, Carlo; Volpe, Alessandro; Carini, Marco; Serni, Sergio.

In: World Journal of Urology, Vol. 32, No. 1, 02.2014, p. 257-263.

Research output: Contribution to journalArticle

Minervini, A, Siena, G, Antonelli, A, Bianchi, G, Bocciardi, AM, Cosciani Cunico, S, Ficarra, V, Fiori, C, Fusco, F, Mari, A, Martorana, G, Medica, M, Mirone, V, Morgia, G, Porpiglia, F, Rocco, F, Rovereto, B, Schiavina, R, Simeone, C, Terrone, C, Volpe, A, Carini, M & Serni, S 2014, 'Open versus laparoscopic partial nephrectomy for clinical T1a renal masses: A matched-pair comparison of 280 patients with TRIFECTA outcomes (RECORd Project)', World Journal of Urology, vol. 32, no. 1, pp. 257-263. https://doi.org/10.1007/s00345-013-1155-7
Minervini, Andrea ; Siena, Giampaolo ; Antonelli, Alessandro ; Bianchi, Giampaolo ; Bocciardi, Aldo Massimo ; Cosciani Cunico, Sergio ; Ficarra, Vincenzo ; Fiori, Cristian ; Fusco, Ferdinando ; Mari, Andrea ; Martorana, Giuseppe ; Medica, Mauro ; Mirone, Vincenzo ; Morgia, Giuseppe ; Porpiglia, Francesco ; Rocco, Francesco ; Rovereto, Bruno ; Schiavina, Riccardo ; Simeone, Claudio ; Terrone, Carlo ; Volpe, Alessandro ; Carini, Marco ; Serni, Sergio. / Open versus laparoscopic partial nephrectomy for clinical T1a renal masses : A matched-pair comparison of 280 patients with TRIFECTA outcomes (RECORd Project). In: World Journal of Urology. 2014 ; Vol. 32, No. 1. pp. 257-263.
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T1 - Open versus laparoscopic partial nephrectomy for clinical T1a renal masses

T2 - A matched-pair comparison of 280 patients with TRIFECTA outcomes (RECORd Project)

AU - Minervini, Andrea

AU - Siena, Giampaolo

AU - Antonelli, Alessandro

AU - Bianchi, Giampaolo

AU - Bocciardi, Aldo Massimo

AU - Cosciani Cunico, Sergio

AU - Ficarra, Vincenzo

AU - Fiori, Cristian

AU - Fusco, Ferdinando

AU - Mari, Andrea

AU - Martorana, Giuseppe

AU - Medica, Mauro

AU - Mirone, Vincenzo

AU - Morgia, Giuseppe

AU - Porpiglia, Francesco

AU - Rocco, Francesco

AU - Rovereto, Bruno

AU - Schiavina, Riccardo

AU - Simeone, Claudio

AU - Terrone, Carlo

AU - Volpe, Alessandro

AU - Carini, Marco

AU - Serni, Sergio

PY - 2014/2

Y1 - 2014/2

N2 - Aim of the study: To report a matched-pair comparative analysis between open (OPN) and laparoscopic partial nephrectomy (LPN) for clinical (c) T1a renal masses from a large prospective multicenter dataset. Materials and methods: The RECORd Project includes all patients who underwent OPN and LPN for kidney cancer between January 2009 and January 2011 at 19 Italian centers. Open and laparoscopic groups were compared regarding clinical, surgical, pathologic, functional results and TRIFECTA outcome. Multivariable logistic regression models were used to analyze predictors of WIT >25 min, surgical complications (SC) and the achievement of the TRIFECTA outcome. Results: Overall, 301 patients had OPN and 149 LPN. Groups were matched 1:1 (140 matched pairs) for clinical diameter, tumor location and type of indication. Laparoscopic partial nephrectomy was associated with a significantly mean longer WIT (19.9 vs. 15.1 min; p <0.001), and it was an independent predictor of a WIT >25 min (RR 6.29, p <0.0001). The TRIFECTA was achieved in 78.6 and 74.3 % after OPN and LPN (p = ns), respectively, and the surgical approach was not a predictor of a negative TRIFECTA and SC at multivariable analysis. At 6-month follow-up, no significant differences were observed between the OPN and LPN group both in estimated glomerular filtration rate (eGFR) ({increment}GFR 1.1 vs. 4.1 mL/min) and in new-onset stage III-V chronic kidney disease (CKD) rate (0 vs. 0.7 %). Conclusion: No significant difference in achieving the TRIFECTA outcome was reported after OPN and LPN. LPN was associated with a significantly longer WIT. However, eGFR at 6-month follow-up did not differ significantly between the two surgical approaches.

AB - Aim of the study: To report a matched-pair comparative analysis between open (OPN) and laparoscopic partial nephrectomy (LPN) for clinical (c) T1a renal masses from a large prospective multicenter dataset. Materials and methods: The RECORd Project includes all patients who underwent OPN and LPN for kidney cancer between January 2009 and January 2011 at 19 Italian centers. Open and laparoscopic groups were compared regarding clinical, surgical, pathologic, functional results and TRIFECTA outcome. Multivariable logistic regression models were used to analyze predictors of WIT >25 min, surgical complications (SC) and the achievement of the TRIFECTA outcome. Results: Overall, 301 patients had OPN and 149 LPN. Groups were matched 1:1 (140 matched pairs) for clinical diameter, tumor location and type of indication. Laparoscopic partial nephrectomy was associated with a significantly mean longer WIT (19.9 vs. 15.1 min; p <0.001), and it was an independent predictor of a WIT >25 min (RR 6.29, p <0.0001). The TRIFECTA was achieved in 78.6 and 74.3 % after OPN and LPN (p = ns), respectively, and the surgical approach was not a predictor of a negative TRIFECTA and SC at multivariable analysis. At 6-month follow-up, no significant differences were observed between the OPN and LPN group both in estimated glomerular filtration rate (eGFR) ({increment}GFR 1.1 vs. 4.1 mL/min) and in new-onset stage III-V chronic kidney disease (CKD) rate (0 vs. 0.7 %). Conclusion: No significant difference in achieving the TRIFECTA outcome was reported after OPN and LPN. LPN was associated with a significantly longer WIT. However, eGFR at 6-month follow-up did not differ significantly between the two surgical approaches.

KW - Kidney cancer

KW - Laparoscopic partial nephrectomy

KW - Laparoscopic versus open matched-pair comparison

KW - Open partial nephrectomy

KW - TRIFECTA

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