Purely Off-Clamp Laparoscopic Partial Nephrectomy Stands the Test of Time: 15 Years Functional and Oncologic Outcomes from a Single Center Experience
Background: Nephron-sparing surgery represents the gold standard treatment for organ-confined renal tumors. We present 15-years of outcomes after off-clamp laparoscopic partial nephrectomy (ocLPN). Methods: a retrospective analysis was performed on patients who underwent ocLPN between May 2001 and D...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-01-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/30/1/92 |
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| author | Aldo Brassetti Umberto Anceschi Alfredo Maria Bove Francesco Prata Manuela Costantini Mariaconsiglia Ferriero Riccardo Mastroianni Leonardo Misuraca Gabriele Tuderti Giulia Torregiani Marco Covotta Michele Gallucci Giuseppe Simone |
| author_facet | Aldo Brassetti Umberto Anceschi Alfredo Maria Bove Francesco Prata Manuela Costantini Mariaconsiglia Ferriero Riccardo Mastroianni Leonardo Misuraca Gabriele Tuderti Giulia Torregiani Marco Covotta Michele Gallucci Giuseppe Simone |
| author_sort | Aldo Brassetti |
| collection | DOAJ |
| description | Background: Nephron-sparing surgery represents the gold standard treatment for organ-confined renal tumors. We present 15-years of outcomes after off-clamp laparoscopic partial nephrectomy (ocLPN). Methods: a retrospective analysis was performed on patients who underwent ocLPN between May 2001 and December 2005. Baseline demographic, clinical, pathologic, surgical, functional and survival data were collected. The Kaplan–Meier method evaluated group-specific oncologic outcomes at 5, 10 and 15 years and the log rank test assessed differences between groups. The same analysis investigated the probabilities of developing a significant renal function impairment (sRFI) and achieving <i>ROMeS</i>. Cox analyses identified predictors of this latter tricomposite outcome. Results: We included 63 patients whose median tumor size was 3 cm (IQR:2–4). At 15 years, the chances of developing local recurrence, metachronous renal cancers or distant metastases were 2 ± 2%, 23 ± 6% and 17 ± 5%, respectively. Consequently, disease-free, cancer-specific and overall-survival probabilities were 68 ± 6%, 90 ± 4% and 72 ± 6%. MCRSS and UCISS well predicted oncologic outcomes. Overall, nine (14%) patients experienced an sRFI and 33 (52%) achieved <i>ROMeS</i>. Age (HR: 1.046; <i>p</i> = 0.033) and malignant histology (low-risk cancers HR: 3.233, <i>p</i> = 0.048) (intermediate/high risk cancers HR: 5.721, <i>p</i> = 0.023) were independent predictors of <i>ROMeS</i> non-achievement. Conclusions: At 15 years from ocLPN, most of patients will experience both excellent functional and oncologic outcomes. |
| first_indexed | 2024-03-09T13:04:33Z |
| format | Article |
| id | doaj.art-32d95e8d07b142debc94e1ea8a2a2e0b |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-09T13:04:33Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-32d95e8d07b142debc94e1ea8a2a2e0b2023-11-30T21:50:09ZengMDPI AGCurrent Oncology1198-00521718-77292023-01-013011196120510.3390/curroncol30010092Purely Off-Clamp Laparoscopic Partial Nephrectomy Stands the Test of Time: 15 Years Functional and Oncologic Outcomes from a Single Center ExperienceAldo Brassetti0Umberto Anceschi1Alfredo Maria Bove2Francesco Prata3Manuela Costantini4Mariaconsiglia Ferriero5Riccardo Mastroianni6Leonardo Misuraca7Gabriele Tuderti8Giulia Torregiani9Marco Covotta10Michele Gallucci11Giuseppe Simone12Department of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, ItalyDepartment of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, ItalyDepartment of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, ItalyDepartment of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, ItalyDepartment of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, ItalyDepartment of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, ItalyDepartment of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, ItalyDepartment of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, ItalyDepartment of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, ItalyDepartment of Anesthesiology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, ItalyDepartment of Anesthesiology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, ItalyDepartment of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, ItalyDepartment of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, ItalyBackground: Nephron-sparing surgery represents the gold standard treatment for organ-confined renal tumors. We present 15-years of outcomes after off-clamp laparoscopic partial nephrectomy (ocLPN). Methods: a retrospective analysis was performed on patients who underwent ocLPN between May 2001 and December 2005. Baseline demographic, clinical, pathologic, surgical, functional and survival data were collected. The Kaplan–Meier method evaluated group-specific oncologic outcomes at 5, 10 and 15 years and the log rank test assessed differences between groups. The same analysis investigated the probabilities of developing a significant renal function impairment (sRFI) and achieving <i>ROMeS</i>. Cox analyses identified predictors of this latter tricomposite outcome. Results: We included 63 patients whose median tumor size was 3 cm (IQR:2–4). At 15 years, the chances of developing local recurrence, metachronous renal cancers or distant metastases were 2 ± 2%, 23 ± 6% and 17 ± 5%, respectively. Consequently, disease-free, cancer-specific and overall-survival probabilities were 68 ± 6%, 90 ± 4% and 72 ± 6%. MCRSS and UCISS well predicted oncologic outcomes. Overall, nine (14%) patients experienced an sRFI and 33 (52%) achieved <i>ROMeS</i>. Age (HR: 1.046; <i>p</i> = 0.033) and malignant histology (low-risk cancers HR: 3.233, <i>p</i> = 0.048) (intermediate/high risk cancers HR: 5.721, <i>p</i> = 0.023) were independent predictors of <i>ROMeS</i> non-achievement. Conclusions: At 15 years from ocLPN, most of patients will experience both excellent functional and oncologic outcomes.https://www.mdpi.com/1718-7729/30/1/92laparoscopylong term outcomespartial nephrectomyrenal cancersurvival |
| spellingShingle | Aldo Brassetti Umberto Anceschi Alfredo Maria Bove Francesco Prata Manuela Costantini Mariaconsiglia Ferriero Riccardo Mastroianni Leonardo Misuraca Gabriele Tuderti Giulia Torregiani Marco Covotta Michele Gallucci Giuseppe Simone Purely Off-Clamp Laparoscopic Partial Nephrectomy Stands the Test of Time: 15 Years Functional and Oncologic Outcomes from a Single Center Experience Current Oncology laparoscopy long term outcomes partial nephrectomy renal cancer survival |
| title | Purely Off-Clamp Laparoscopic Partial Nephrectomy Stands the Test of Time: 15 Years Functional and Oncologic Outcomes from a Single Center Experience |
| title_full | Purely Off-Clamp Laparoscopic Partial Nephrectomy Stands the Test of Time: 15 Years Functional and Oncologic Outcomes from a Single Center Experience |
| title_fullStr | Purely Off-Clamp Laparoscopic Partial Nephrectomy Stands the Test of Time: 15 Years Functional and Oncologic Outcomes from a Single Center Experience |
| title_full_unstemmed | Purely Off-Clamp Laparoscopic Partial Nephrectomy Stands the Test of Time: 15 Years Functional and Oncologic Outcomes from a Single Center Experience |
| title_short | Purely Off-Clamp Laparoscopic Partial Nephrectomy Stands the Test of Time: 15 Years Functional and Oncologic Outcomes from a Single Center Experience |
| title_sort | purely off clamp laparoscopic partial nephrectomy stands the test of time 15 years functional and oncologic outcomes from a single center experience |
| topic | laparoscopy long term outcomes partial nephrectomy renal cancer survival |
| url | https://www.mdpi.com/1718-7729/30/1/92 |
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