Comparison of Tumor Enucleation and Standard Partial Nephrectomy According to Trifecta Outcomes: A Multicenter Study by the Turkish Academy of Urology, Uro-Oncology Working Group
Introduction We aimed to evaluate the impact of the resection technique (tumor enucleation (TE) or standard partial nephrectomy (SPN)) on trifecta outcomes in patients having undergone partial nephrectomy (PN). Materials and Methods We retrospectively analyzed the clinical and pathologic parameters...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-05-01
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| Series: | Journal of Investigative Surgery |
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| Online Access: | http://dx.doi.org/10.1080/08941939.2021.2015490 |
| _version_ | 1797684507674935296 |
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| author | Meftun Culpan Gokhan Atis Oner Sanli Yasar Bozkurt Ali Fuat Atmaca Bülent Semerci Cemil Kutsal Abdullah Erdem Canda Fatih Akbulut Volkan Tugcu Ugur Boylu Sakip Erturhan Orhan Koca Ferhat Ateş Fikret Halis Sedat Soyupek Burak Turna Sedat Cakmak Selcuk Sahin Selcuk Erdem Asif Yildirim |
| author_facet | Meftun Culpan Gokhan Atis Oner Sanli Yasar Bozkurt Ali Fuat Atmaca Bülent Semerci Cemil Kutsal Abdullah Erdem Canda Fatih Akbulut Volkan Tugcu Ugur Boylu Sakip Erturhan Orhan Koca Ferhat Ateş Fikret Halis Sedat Soyupek Burak Turna Sedat Cakmak Selcuk Sahin Selcuk Erdem Asif Yildirim |
| author_sort | Meftun Culpan |
| collection | DOAJ |
| description | Introduction We aimed to evaluate the impact of the resection technique (tumor enucleation (TE) or standard partial nephrectomy (SPN)) on trifecta outcomes in patients having undergone partial nephrectomy (PN). Materials and Methods We retrospectively analyzed the clinical and pathologic parameters in patients with localized renal cell carcinoma (pT1–2N0M0) who had undergone PN between January 2001–December 2018 at one of 15 different tertiary referral centers. Multivariable logistic regression analysis was applied to investigate independent predictors of trifecta failure, decreased postoperative renal functions (decreased estimated glomerular filtration rate (eGFR) > 10%), perioperative complications (Clavien–Dindo > 1), and positive surgical margins. Results A total of 1070 patients with a mean age 56.11 ± 11.88 years were included in our study. PN was performed with TE in 848 (79.25%) and SPN in 222 (20.75%) patients. Trifecta failure rate was 56.2% for TE and 64.4% for SPN (p = 0.028). On multivariable analysis, TE was associated with less trifecta failure (p = 0.025) and eGFR decrease >10% rates (p = 0.024). On the other hand, there was no statistically significant difference between TE and SPN according to positive surgical margins (p = 0.450) and complication > Clavien-Dindo grade 1 (p = 0.888) rates. The only independent predictive factor for complications > Clavien–Dindo 1 was the Charlson comorbidity index (CCI) (p = 0.001). Conclusion TE is associated with less trifecta failure than SPN. This result is mainly due to better preservation of renal function with TE. |
| first_indexed | 2024-03-12T00:30:39Z |
| format | Article |
| id | doaj.art-e55f0ffeae624564809deddabc256720 |
| institution | Directory Open Access Journal |
| issn | 0894-1939 1521-0553 |
| language | English |
| last_indexed | 2024-03-12T00:30:39Z |
| publishDate | 2022-05-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Investigative Surgery |
| spelling | doaj.art-e55f0ffeae624564809deddabc2567202023-09-15T10:21:29ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532022-05-013551112111810.1080/08941939.2021.20154902015490Comparison of Tumor Enucleation and Standard Partial Nephrectomy According to Trifecta Outcomes: A Multicenter Study by the Turkish Academy of Urology, Uro-Oncology Working GroupMeftun Culpan0Gokhan Atis1Oner Sanli2Yasar Bozkurt3Ali Fuat Atmaca4Bülent Semerci5Cemil Kutsal6Abdullah Erdem Canda7Fatih Akbulut8Volkan Tugcu9Ugur Boylu10Sakip Erturhan11Orhan Koca12Ferhat Ateş13Fikret Halis14Sedat Soyupek15Burak Turna16Sedat Cakmak17Selcuk Sahin18Selcuk Erdem19Asif Yildirim20Department of Urology, Faculty of Medicine, Istanbul Medeniyet UniversityDepartment of Urology, Faculty of Medicine, Istanbul Medeniyet UniversityDepartment of Urology, Istanbul Faculty of Medicine, Istanbul UniversityDepartment of Urology, Faculty of Medicine, Dicle UniversityFaculty of Medicine, Department of Urology, Ankara Yildirim Beyazit UniversityFaculty of Medicine, Department of Urology, Ege UniversityDepartment of Urology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research HospitalSchool of Medicine, Department of Urology, Koc UniversityDepartment of Urology, University of Health Sciences, Haseki Training and Research HospitalDepartment of Urology, University of Health Sciences, Bakirkoy Sadi Konuk Training and Research HospitalDepartment of Urology, University of Health Sciences, Umraniye Training and Research HospitalSchool of Medicine, Department of Urology, Gaziantep UniversityDepartment of Urology, University of Health Sciences, Haydarpasa Training and Research HospitalDepartment of Urology, University of Health Sciences, Sultan 2. Abdulhamid Han Training and Research HospitalDepartment of Urology, Sakarya University Training and Research HospitalSchool of Medicine, Department of Urology, Suleyman Demirel UniversityFaculty of Medicine, Department of Urology, Ege UniversityDepartment of Urology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research HospitalDepartment of Urology, University of Health Sciences, Bakirkoy Sadi Konuk Training and Research HospitalDepartment of Urology, Istanbul Faculty of Medicine, Istanbul UniversityDepartment of Urology, Faculty of Medicine, Istanbul Medeniyet UniversityIntroduction We aimed to evaluate the impact of the resection technique (tumor enucleation (TE) or standard partial nephrectomy (SPN)) on trifecta outcomes in patients having undergone partial nephrectomy (PN). Materials and Methods We retrospectively analyzed the clinical and pathologic parameters in patients with localized renal cell carcinoma (pT1–2N0M0) who had undergone PN between January 2001–December 2018 at one of 15 different tertiary referral centers. Multivariable logistic regression analysis was applied to investigate independent predictors of trifecta failure, decreased postoperative renal functions (decreased estimated glomerular filtration rate (eGFR) > 10%), perioperative complications (Clavien–Dindo > 1), and positive surgical margins. Results A total of 1070 patients with a mean age 56.11 ± 11.88 years were included in our study. PN was performed with TE in 848 (79.25%) and SPN in 222 (20.75%) patients. Trifecta failure rate was 56.2% for TE and 64.4% for SPN (p = 0.028). On multivariable analysis, TE was associated with less trifecta failure (p = 0.025) and eGFR decrease >10% rates (p = 0.024). On the other hand, there was no statistically significant difference between TE and SPN according to positive surgical margins (p = 0.450) and complication > Clavien-Dindo grade 1 (p = 0.888) rates. The only independent predictive factor for complications > Clavien–Dindo 1 was the Charlson comorbidity index (CCI) (p = 0.001). Conclusion TE is associated with less trifecta failure than SPN. This result is mainly due to better preservation of renal function with TE.http://dx.doi.org/10.1080/08941939.2021.2015490complicationenucleationpartial nephrectomyrcctrifecta |
| spellingShingle | Meftun Culpan Gokhan Atis Oner Sanli Yasar Bozkurt Ali Fuat Atmaca Bülent Semerci Cemil Kutsal Abdullah Erdem Canda Fatih Akbulut Volkan Tugcu Ugur Boylu Sakip Erturhan Orhan Koca Ferhat Ateş Fikret Halis Sedat Soyupek Burak Turna Sedat Cakmak Selcuk Sahin Selcuk Erdem Asif Yildirim Comparison of Tumor Enucleation and Standard Partial Nephrectomy According to Trifecta Outcomes: A Multicenter Study by the Turkish Academy of Urology, Uro-Oncology Working Group Journal of Investigative Surgery complication enucleation partial nephrectomy rcc trifecta |
| title | Comparison of Tumor Enucleation and Standard Partial Nephrectomy According to Trifecta Outcomes: A Multicenter Study by the Turkish Academy of Urology, Uro-Oncology Working Group |
| title_full | Comparison of Tumor Enucleation and Standard Partial Nephrectomy According to Trifecta Outcomes: A Multicenter Study by the Turkish Academy of Urology, Uro-Oncology Working Group |
| title_fullStr | Comparison of Tumor Enucleation and Standard Partial Nephrectomy According to Trifecta Outcomes: A Multicenter Study by the Turkish Academy of Urology, Uro-Oncology Working Group |
| title_full_unstemmed | Comparison of Tumor Enucleation and Standard Partial Nephrectomy According to Trifecta Outcomes: A Multicenter Study by the Turkish Academy of Urology, Uro-Oncology Working Group |
| title_short | Comparison of Tumor Enucleation and Standard Partial Nephrectomy According to Trifecta Outcomes: A Multicenter Study by the Turkish Academy of Urology, Uro-Oncology Working Group |
| title_sort | comparison of tumor enucleation and standard partial nephrectomy according to trifecta outcomes a multicenter study by the turkish academy of urology uro oncology working group |
| topic | complication enucleation partial nephrectomy rcc trifecta |
| url | http://dx.doi.org/10.1080/08941939.2021.2015490 |
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