BACKGROUND: The aim of this study was to assess the long-term oncologic and functional outcomes in elderly patients having undergone robot-assisted partial nephrectomy (RAPN) for renal cancer (RC). METHODS: Sixty-one patients out of 323 who underwent RAPN for localized RC between July 2009 and March 2016 in our high-volume robotic surgery center (>800 procedures/year), had 70 years or more. Inclusion criteria of the study were age ≥70 years; pathological confirmed RCC and ASA Score ≤3. All patients were stratified according to PADUA classification system in three groups: <7 points, 8-9 points, >10 points. Trifecta was defined as a warm ischemia time (WIT) less then 25 min, negative surgical margins and no perioperative complications. RESULTS: A total of 52 patients were included; median follow-up was 47 months. Median age was 74 yrs. (IQR 72-76.5). Complication rate was 15.4%. Trifecta failure was associated to PADUA Score (P=0.02), and tumor diameter (P=0.04). Renal function was altered in 10 (19.2%) patients before surgery and at last follow-up in 11 (21.1%) patients (CKD stage>2) The DFS, OS and CSS were 89.33%, 90.06% and 94.4%, respectively. CONCLUSIONS: In a high-volume center, robot-assisted approach is feasible and safe in surgical fit elderly patients with good long-term oncologic outcomes.

Long-term oncologic and functional outcomes after robot-assisted partial nephrectomy in elderly patients / M.D. Vartolomei, D.V. Matei, G. Renne, V.M. Tringali, N. Crișan, G. Musi, F.A. Mistretta, A. Russo, A. Conti, G. Cozzi, S. Luzzago, M. Catellani, A. Cioffi, G. Cordima, R. Bianchi, E. Di Trapani, A. Serino, M. Delor, R. Bianco, D. Bottero, M. Ferro, O. de Cobelli. - In: MINERVA UROLOGICA E NEFROLOGICA. - ISSN 0393-2249. - 71:1(2019), pp. 31-37.

Long-term oncologic and functional outcomes after robot-assisted partial nephrectomy in elderly patients

G. Musi;F.A. Mistretta;A. Conti;S. Luzzago;O. de Cobelli
2019

Abstract

BACKGROUND: The aim of this study was to assess the long-term oncologic and functional outcomes in elderly patients having undergone robot-assisted partial nephrectomy (RAPN) for renal cancer (RC). METHODS: Sixty-one patients out of 323 who underwent RAPN for localized RC between July 2009 and March 2016 in our high-volume robotic surgery center (>800 procedures/year), had 70 years or more. Inclusion criteria of the study were age ≥70 years; pathological confirmed RCC and ASA Score ≤3. All patients were stratified according to PADUA classification system in three groups: <7 points, 8-9 points, >10 points. Trifecta was defined as a warm ischemia time (WIT) less then 25 min, negative surgical margins and no perioperative complications. RESULTS: A total of 52 patients were included; median follow-up was 47 months. Median age was 74 yrs. (IQR 72-76.5). Complication rate was 15.4%. Trifecta failure was associated to PADUA Score (P=0.02), and tumor diameter (P=0.04). Renal function was altered in 10 (19.2%) patients before surgery and at last follow-up in 11 (21.1%) patients (CKD stage>2) The DFS, OS and CSS were 89.33%, 90.06% and 94.4%, respectively. CONCLUSIONS: In a high-volume center, robot-assisted approach is feasible and safe in surgical fit elderly patients with good long-term oncologic outcomes.
Aged-Robotic surgical procedures; Carcinoma, renal cell; Elderly; Aged; Aged, 80 and over; Carcinoma, Renal Cell; Female; Humans; Kidney Neoplasms; Male; Nephrectomy; Postoperative Complications; Retrospective Studies; Robotic Surgical Procedures; Treatment Outcome; Warm Ischemia; Nephrology; Urology
Settore MED/24 - Urologia
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/640790
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