To describe the most recent surgical, functional, and oncological outcomes of RPN utilizing one of the largest, prospectively maintained, multi-institution consortium of patients undergoing robotic renal surgery.
Data was obtained from a prospectively maintained multi-institutional database of patients who underwent RPN for clinically localized kidney cancer between 2018 and 2022 by nine high-volume surgeons. Demographic and tumor characteristics as well as operative, functional, and oncological outcomes were queried.
A total of 2,836 patients underwent RPN. Intraoperative, postoperative, and 30-day major complication rates were 2.68%, 11.39%, and 3.24%, respectively. Median tumor size was 3.0 cm. Tumors with low complexity had a shorter median operative time, lower median EBL, shorter median ischemia time, lower postoperative complication rate, and lower decline in renal function There was no significant difference between tumor complexities with respect to the rate of conversion to radical nephrectomy, conversion to open, major complications, and positive margins. Lower BMI, smaller clinical tumor size, lower tumor complexity, and higher baseline eGFR were significantly associated with trifecta achievement.
Patient BMI, baseline eGFR, and tumor characteristics such as size and complexity are the most important predictors of trifecta achievement. Patients with complex tumors should be counseled that they are at increased risk of complications and worsening renal function after robotic partial nephrectomy.
Urology. 2022 Dec 30 [Epub ahead of print]
Shirin Razdan, Kennedy E Okhawere, Burak Ucpinar, Indu Saini, Antony Deluxe, Ronney Abaza, Daniel D Eun, Akshay Bhandari, Ashok K Hemal, James Porter, Michael D Stifelman, Simone Crivellaro, Phillip M Pierorazio, Ketan K Badani
Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: ., Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Central Ohio Urology Group and Mount Carmel Health System Prostate Cancer Program, Columbus, OH., Department of Urology, Lewis Katz School of Medicine Temple University, Philadelphia, PA., Division of Urology, Mount Sinai Medical Center, Miami Beach, FL., Department of Urology, Wake Forest School of Medicine, Winston-Salem, NC., Department of Urology, Swedish Urology, Seattle, WA., Department of Urology, Hackensack University Medical Center, Hackensack, NJ, USA., Department of Urology, University of Illinois, Chicago., Department of Urology, University of Pennsylvania, Philadelphia, PA.