Simple enucleation versus standard partial nephrectomy for clinical T1 renal masses: Perioperative outcomes based on a matched-pair comparison of 396 patients (RECORd project)

N. Longo, A. Minervini, A. Antonelli, G. Bianchi, A. M. Bocciardi, S. C. Cunico, C. Fiori, F. Fusco, S. Giancane, A. Mari, G. Martorana, V. Mirone, G. Morgia, G. Novara, F. Porpiglia, M. R. Raspollini, F. Rocco, B. Rovereto, R. Schiavina, S. SerniC. Simeone, P. Verze, A. Volpe, V. Ficarra, M. Carini

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Objectives To compare simple enucleation (SE) and standard partial nephrectomy (SPN) in terms of surgical results in a multicenter dataset (RECORd Project). Materials and methods patients treated with nephron sparing surgery (NSS) for clinical T1 renal tumors between January 2009 and January 2011 were evaluated. Overall, 198 patients who underwent SE were retrospectively matched to 198 patients who underwent SPN. The SPN and SE groups were compared regarding intraoperative, early post-operative and pathologic outcome variables. Multivariable analysis was applied to analyze predictors of positive surgical margin (PSM) status. Results SE was associated with similar WIT (18 vs 17.8 min), lower intraoperative blood loss (177 vs 221 cc, p = 0.02) and shorter operative time (121 vs 147 min; p <0.0001). Surgical approach (laparoscopic vs. open), tumor size and type of indication (elective/relative vs absolute) were associated with WIT >20 min. The incidence of PSM was significantly lower in patients treated with SE (1.4% vs 6.9%; p = 0.02). At multivariable analysis, PSM was related to the surgical technique, with a 4.7-fold increased risk of PSM for SPN compared to SE. The incidence of overall, medical and surgical complications was similar between SE and SPN. Conclusions Type of NSS technique (SE vs SPN) adopted has a negligible impact on WIT and postoperative morbidity but SE seems protective against PSM occurrence.

Original languageEnglish
Pages (from-to)762-768
Number of pages7
JournalEuropean Journal of Surgical Oncology
Volume40
Issue number6
DOIs
Publication statusPublished - 2014

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Nephrectomy
Kidney
Nephrons
Incidence
Operative Time
Margins of Excision
Morbidity
Neoplasms

Keywords

  • Carcinoma
  • Partial nephrectomy
  • Pathology
  • Renal cell
  • Simple enucleation
  • Surgical outcome assessment

ASJC Scopus subject areas

  • Oncology
  • Surgery

Cite this

Simple enucleation versus standard partial nephrectomy for clinical T1 renal masses : Perioperative outcomes based on a matched-pair comparison of 396 patients (RECORd project). / Longo, N.; Minervini, A.; Antonelli, A.; Bianchi, G.; Bocciardi, A. M.; Cunico, S. C.; Fiori, C.; Fusco, F.; Giancane, S.; Mari, A.; Martorana, G.; Mirone, V.; Morgia, G.; Novara, G.; Porpiglia, F.; Raspollini, M. R.; Rocco, F.; Rovereto, B.; Schiavina, R.; Serni, S.; Simeone, C.; Verze, P.; Volpe, A.; Ficarra, V.; Carini, M.

In: European Journal of Surgical Oncology, Vol. 40, No. 6, 2014, p. 762-768.

Research output: Contribution to journalArticle

Longo, N, Minervini, A, Antonelli, A, Bianchi, G, Bocciardi, AM, Cunico, SC, Fiori, C, Fusco, F, Giancane, S, Mari, A, Martorana, G, Mirone, V, Morgia, G, Novara, G, Porpiglia, F, Raspollini, MR, Rocco, F, Rovereto, B, Schiavina, R, Serni, S, Simeone, C, Verze, P, Volpe, A, Ficarra, V & Carini, M 2014, 'Simple enucleation versus standard partial nephrectomy for clinical T1 renal masses: Perioperative outcomes based on a matched-pair comparison of 396 patients (RECORd project)', European Journal of Surgical Oncology, vol. 40, no. 6, pp. 762-768. https://doi.org/10.1016/j.ejso.2014.01.007
Longo, N. ; Minervini, A. ; Antonelli, A. ; Bianchi, G. ; Bocciardi, A. M. ; Cunico, S. C. ; Fiori, C. ; Fusco, F. ; Giancane, S. ; Mari, A. ; Martorana, G. ; Mirone, V. ; Morgia, G. ; Novara, G. ; Porpiglia, F. ; Raspollini, M. R. ; Rocco, F. ; Rovereto, B. ; Schiavina, R. ; Serni, S. ; Simeone, C. ; Verze, P. ; Volpe, A. ; Ficarra, V. ; Carini, M. / Simple enucleation versus standard partial nephrectomy for clinical T1 renal masses : Perioperative outcomes based on a matched-pair comparison of 396 patients (RECORd project). In: European Journal of Surgical Oncology. 2014 ; Vol. 40, No. 6. pp. 762-768.
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abstract = "Objectives To compare simple enucleation (SE) and standard partial nephrectomy (SPN) in terms of surgical results in a multicenter dataset (RECORd Project). Materials and methods patients treated with nephron sparing surgery (NSS) for clinical T1 renal tumors between January 2009 and January 2011 were evaluated. Overall, 198 patients who underwent SE were retrospectively matched to 198 patients who underwent SPN. The SPN and SE groups were compared regarding intraoperative, early post-operative and pathologic outcome variables. Multivariable analysis was applied to analyze predictors of positive surgical margin (PSM) status. Results SE was associated with similar WIT (18 vs 17.8 min), lower intraoperative blood loss (177 vs 221 cc, p = 0.02) and shorter operative time (121 vs 147 min; p <0.0001). Surgical approach (laparoscopic vs. open), tumor size and type of indication (elective/relative vs absolute) were associated with WIT >20 min. The incidence of PSM was significantly lower in patients treated with SE (1.4{\%} vs 6.9{\%}; p = 0.02). At multivariable analysis, PSM was related to the surgical technique, with a 4.7-fold increased risk of PSM for SPN compared to SE. The incidence of overall, medical and surgical complications was similar between SE and SPN. Conclusions Type of NSS technique (SE vs SPN) adopted has a negligible impact on WIT and postoperative morbidity but SE seems protective against PSM occurrence.",
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T1 - Simple enucleation versus standard partial nephrectomy for clinical T1 renal masses

T2 - Perioperative outcomes based on a matched-pair comparison of 396 patients (RECORd project)

AU - Longo, N.

AU - Minervini, A.

AU - Antonelli, A.

AU - Bianchi, G.

AU - Bocciardi, A. M.

AU - Cunico, S. C.

AU - Fiori, C.

AU - Fusco, F.

AU - Giancane, S.

AU - Mari, A.

AU - Martorana, G.

AU - Mirone, V.

AU - Morgia, G.

AU - Novara, G.

AU - Porpiglia, F.

AU - Raspollini, M. R.

AU - Rocco, F.

AU - Rovereto, B.

AU - Schiavina, R.

AU - Serni, S.

AU - Simeone, C.

AU - Verze, P.

AU - Volpe, A.

AU - Ficarra, V.

AU - Carini, M.

PY - 2014

Y1 - 2014

N2 - Objectives To compare simple enucleation (SE) and standard partial nephrectomy (SPN) in terms of surgical results in a multicenter dataset (RECORd Project). Materials and methods patients treated with nephron sparing surgery (NSS) for clinical T1 renal tumors between January 2009 and January 2011 were evaluated. Overall, 198 patients who underwent SE were retrospectively matched to 198 patients who underwent SPN. The SPN and SE groups were compared regarding intraoperative, early post-operative and pathologic outcome variables. Multivariable analysis was applied to analyze predictors of positive surgical margin (PSM) status. Results SE was associated with similar WIT (18 vs 17.8 min), lower intraoperative blood loss (177 vs 221 cc, p = 0.02) and shorter operative time (121 vs 147 min; p <0.0001). Surgical approach (laparoscopic vs. open), tumor size and type of indication (elective/relative vs absolute) were associated with WIT >20 min. The incidence of PSM was significantly lower in patients treated with SE (1.4% vs 6.9%; p = 0.02). At multivariable analysis, PSM was related to the surgical technique, with a 4.7-fold increased risk of PSM for SPN compared to SE. The incidence of overall, medical and surgical complications was similar between SE and SPN. Conclusions Type of NSS technique (SE vs SPN) adopted has a negligible impact on WIT and postoperative morbidity but SE seems protective against PSM occurrence.

AB - Objectives To compare simple enucleation (SE) and standard partial nephrectomy (SPN) in terms of surgical results in a multicenter dataset (RECORd Project). Materials and methods patients treated with nephron sparing surgery (NSS) for clinical T1 renal tumors between January 2009 and January 2011 were evaluated. Overall, 198 patients who underwent SE were retrospectively matched to 198 patients who underwent SPN. The SPN and SE groups were compared regarding intraoperative, early post-operative and pathologic outcome variables. Multivariable analysis was applied to analyze predictors of positive surgical margin (PSM) status. Results SE was associated with similar WIT (18 vs 17.8 min), lower intraoperative blood loss (177 vs 221 cc, p = 0.02) and shorter operative time (121 vs 147 min; p <0.0001). Surgical approach (laparoscopic vs. open), tumor size and type of indication (elective/relative vs absolute) were associated with WIT >20 min. The incidence of PSM was significantly lower in patients treated with SE (1.4% vs 6.9%; p = 0.02). At multivariable analysis, PSM was related to the surgical technique, with a 4.7-fold increased risk of PSM for SPN compared to SE. The incidence of overall, medical and surgical complications was similar between SE and SPN. Conclusions Type of NSS technique (SE vs SPN) adopted has a negligible impact on WIT and postoperative morbidity but SE seems protective against PSM occurrence.

KW - Carcinoma

KW - Partial nephrectomy

KW - Pathology

KW - Renal cell

KW - Simple enucleation

KW - Surgical outcome assessment

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