To analyze the trifecta results in patients with T1a and T1b renal tumors treated with retroperitoneoscopic partial nephrectomy (RPN).
A cross-sectional prospective observational study was conducted on 106 patients with cT1 renal tumor submitted to RPN. Trifecta was reported as no ≥ 2 Clavien-Dindo complications, warm ischemia time (WIT) ≤ 25 minutes, ≤ 15% postoperative ΔGFR, and nonpositive margins.
The mean age was 58 years (SD ± 12). The median (Q1; Q3) tumor size was 3.5 (2.2; 4.5) cm. Of the treated patients, 33% had a ventral tumor. R.E.N.A.L nephrometry score was low complexity in 54% of cases and high complexity in 4%. WIT median (Q1; Q3) was 20 (14; 23) minutes. Estimated blood loss median (Q1; Q3) was 50 (0; 100) ml. There were no conversions to open surgery. ΔGFR was >15% in 17.5% of patients. There were no postoperative complications in 84% of cases. Nonpositive margins were observed. Sixty-eight percent were pT1a and 32% were pT1b. Seventy-two percent of patients presented trifecta. A statistically significant difference was found between trifecta and tumor size (3 cm vs. 4.4 cm; p<0.001), complexity (low complexity 90% vs. intermediate complexity 56%; p<0.0001), and pT (T1a 81% vs. T1b 53%; p<0.003).
RPN is a safe and effective treatment modality for T1a and T1b renal tumors. Trifecta rate was 72%. Tumor size, tumor complexity, and pT were found to be an associated factor for trifecta.
Archivos espanoles de urologia. 2022 Jun [Epub]
Miguel Angel Bergero, Lucas Costa, Patricio Modina, Fernando Dipatto, Carlos David, Eder Silveira Brazao
Departamento de Urología. Sanatorio Privado San Gerónimo. Santiago del Estero 2750, CP3000, Santa Fe. Argentina., Departamento de Bioestadística. Facultad de Medicina. Universidad Nacional del Litoral. Ciudad Universitaria. RN168 80. CP 3000. Santa Fe.Argentina., Departamento de Urología. AC Camargo Cancer Center. São Paulo. Brazil.