6 results on '"Rodriguez Faba, Oscar"'
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2. Partial versus radical nephrectomy in very elderly patients: a propensity score analysis of surgical, functional and oncologic outcomes (RESURGE project)
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Mir, Maria C., Pavan, Nicola, Capitanio, Umberto, Antonelli, Alessandro, Derweesh, Ithaar, Rodriguez-Faba, Oscar, Linares, Estefania, Takagi, Toshio, Rha, Koon H., Fiori, Christian, Maurer, Tobias, Zang, Chao, Mottrie, Alexandre, Umari, Paolo, Long, Jean-Alexandre, Fiard, Gaelle, De Nunzio, Cosimo, Tubaro, Andrea, Tracey, Andrew T., Ferro, Matteo, De Cobelli, Ottavio, Micali, Salvatore, Bevilacqua, Luigi, Torres, João, Schips, Luigi, Castellucci, Roberto, Dobbs, Ryan, Quarto, Giuseppe, Bove, Pierluigi, Celia, Antonio, De Concilio, Bernardino, Trombetta, Carlo, Silvestri, Tommaso, Larcher, Alessandro, Montorsi, Francesco, Palumbo, Carlotta, Furlan, Maria, Bindayi, Ahmet, Hamilton, Zachary, Breda, Alberto, Palou, Joan, Aguilera, Alfredo, Tanabe, Kazunari, Raheem, Ali, Amiel, Thomas, Yang, Bo, Lima, Estevão, Crivellaro, Simone, Perdona, Sisto, Gregorio, Caterina, Barbati, Giulia, Porpiglia, Francesco, and Autorino, Riccardo
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- 2020
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3. Predictors of Positive Surgical Margins after Robot-Assisted Partial Nephrectomy for Localized Renal Tumors: Insights from a Large Multicenter International Prospective Observational Project (The Surface-Intermediate-Base Margin Score Consortium).
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Di Maida, Fabrizio, Campi, Riccardo, Lane, Brian R., De Cobelli, Ottavio, Sanguedolce, Francesco, Hatzichristodoulou, Georgios, Antonelli, Alessandro, Grosso, Antonio Andrea, Noyes, Sabrina, Rodriguez-Faba, Oscar, Keeley, Frank X., Langenhuijsen, Johan, Musi, Gennaro, Klatte, Tobias, Roscigno, Marco, Akdogan, Bulent, Furlan, Maria, Simeone, Claudio, Karakoyunlu, Nihat, and Marszalek, Martin
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NEPHRECTOMY ,SURGICAL margin ,KIDNEY tumors ,SURGICAL robots - Abstract
Background: To explore predictors of positive surgical margins (PSM) after robotic partial nephrectomy (PN) in a large multicenter international observational project, harnessing the Surface-Intermediate-Base (SIB) margin score to report the resection technique after PN in a standardized way. Methods: Data from consecutive patients with cT1-2N0M0 renal masses treated with PN from September 2014 to March 2015 at 16 tertiary referral centers and included in the SIB margin score International Consortium were prospectively collected. For the present study, only patients treated with robotic PN were included. Uni- and multivariable analysis were fitted to explore clinical and surgical predictors of PSMs after PN. Results: Overall, 289 patients were enrolled. Median (IQR) preoperative tumor size was 3.0 (2.3–4.2) cm and median (IQR) PADUA score was 8 (7–9). SIB scores of 0–2 (enucleation), 3–4 (enucleoresection) and 5 (resection) were reported in 53.3%, 27.3% and 19.4% of cases, respectively. A PSM was recorded in 18 (6.2%) patients. PSM rate was 4.5%, 11.4% and 3.6% in case of enucleation, enucleoresection and resection, respectively. Patients with PSMs had tumors with a higher rate of contact with the urinary collecting system (55.6% vs. 27.3%; p < 0.001) and a longer median warm ischemia time (22 vs. 16 min; p = 0.02) compared with patients with negative surgical margins, while no differences emerged between the two groups in terms of other tumor features (i.e., pathological diameter, PADUA score). In multivariable analysis, only enucleoresection (SIB score 3–4) versus enucleation (SIB score 0–2) was found to be an independent predictor of PSM at final pathology (HR: 2.68; 95% CI: 1.25–7.63; p = 0.04), while resection (SIB score 5) was not. Conclusions: In our experience, enucleoresection led to a higher risk of PSMs as compared to enucleation. Further studies are needed to assess the differential impacts of resection technique and surgeon's experience on margin status after robotic PN. [ABSTRACT FROM AUTHOR]
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- 2022
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4. Impact of surgical approach and resection technique on the risk of Trifecta Failure after partial nephrectomy for highly complex renal masses.
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Campi, Riccardo, Di Maida, Fabrizio, Lane, Brian R., De Cobelli, Ottavio, Sanguedolce, Francesco, Hatzichristodoulou, Georgios, Antonelli, Alessandro, Noyes, Sabrina, Mari, Andrea, Grosso, Antonio Andrea, Rodriguez-Faba, Oscar, Keeley, Frank X., Langenhuijsen, Johan, Musi, Gennaro, Klatte, Tobias, Roscigno, Marco, Akdogan, Bulent, Furlan, Maria, Karakoyunlu, Nihat, and Marszalek, Martin
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NEPHRECTOMY ,SURGICAL excision ,SURGICAL margin ,ACUTE kidney failure ,LOGISTIC regression analysis ,SURGICAL complications - Abstract
We aimed to compare the outcomes of open vs robotic partial nephrectomy (PN), focusing on predictors of Trifecta failure in patients with highly complex renal masses. We queried the prospectively collected database from the SIB International Consortium, including 507 consecutive patients with cT1-2N0M0 renal masses treated at 16 high-volume referral centres, to select those with highly complex (PADUA score ≥10) tumors undergoing PN. RT was classified as enucleation, enucleoresection or resection according to the SIB score. Trifecta was defined as achievement of negative surgical margins, no acute kidney injury and no Clavien-Dindo grade ≥2 postoperative surgical complications. Multivariable logistic regression analysis was used to assess independent predictors of Trifecta failure. 113 patients were included. Patients undergoing open PN (n = 47, 41.6%) and robotic PN (n = 66, 58.4%) were comparable in baseline characteristics. RT was classified as enucleation, enucleoresection and resection in 46.9%, 34.0% and 19.1% of open PN, and in 50.0%, 40.9% and 9.1% of robotic PN (p = 0.28). Trifecta was achieved in significantly more patients after robotic PN (69.7% vs. 42.6%, p = 0.004). On multivariable analysis, surgical approach (open vs robotic, OR: 2.62; 95%CI: 1.11–6.15, p = 0.027) and tumor complexity (OR for each additional unit of the PADUA score: 2.27; 95%CI: 1.27–4.06, p = 0.006) were significant predictors of Trifecta failure, while RT was not. The study is limited by lack of randomization; as such, selection bias and confounding cannot be entirely ruled out. Tumor complexity and surgical approach were independent predictors of Trifecta failure after PN for highly complex renal masses. [ABSTRACT FROM AUTHOR]
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- 2022
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5. Does the Unexpected Presence of Non-organ-confined Disease at Final Pathology Undermine Cancer Control in Patients with Clinical T1N0M0 Renal Cell Carcinoma Who Underwent Partial Nephrectomy?
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Idir Ouzaid, Paolo Dell'Oglio, Andrea Minervini, James Lingard, Maciej Salagierski, Grant D. Stewart, Sabine Brookman-May, Maria Carmen Mir, Marco Carini, Oscar Rodriguez Faba, Bulent Akdogan, Francesco Montorsi, Marco Roscigno, Luigi F. Da Pozzo, Tobias Klatte, Emanuele Zaffuto, Christian G. Stief, Martin Marszalek, Umberto Capitanio, Capitanio, Umberto, Stewart, Grant D., Klatte, Tobia, Akdogan, Bulent, Roscigno, Marco, Marszalek, Martin, Dell'Oglio, Paolo, Zaffuto, Emanuele, Rodriguez Faba, Oscar, Salagierski, Maciej, Lingard, Jame, Carini, Marco, Ouzaid, Idir, Mir, Maria Carmen, Montorsi, Francesco, Da Pozzo, Luigi Filippo, Stief, Christian, Minervini, Andrea, Brookman-May, Sabine D., Stewart, Grant [0000-0003-3188-9140], Apollo - University of Cambridge Repository, Capitanio, U, Stewart, G, Klatte, T, Akdogan, B, Roscigno, M, Marszalek, M, Dell'Oglio, P, Zaffuto, E, Rodriguez Faba, O, Salagierski, M, Lingard, J, Carini, M, Ouzaid, I, Mir, M, Montorsi, F, Da Pozzo, L, Stief, C, Minervini, A, and Brookman-May, S
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Male ,Pathology ,medicine.medical_treatment ,030232 urology & nephrology ,Kaplan-Meier Estimate ,Disease ,Nephrectomy ,0302 clinical medicine ,Retrospective Studie ,cancer control ,Renal cell carcinoma ,Partial nephrectomy ,Medicine ,Neoplasm Metastasis ,Multivariate Analysi ,Upstaging ,Kidney ,Cancer control ,Kidney cancer ,Radical nephrectomy ,Renal cancer ,Kidney Neoplasm ,kidney cancer ,Middle Aged ,Kidney Neoplasms ,Neoplasm Metastasi ,Treatment Outcome ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Disease Progression ,Female ,Human ,radical nephrectomy ,medicine.medical_specialty ,partial nephrectomy ,Urology ,renal cancer ,03 medical and health sciences ,Humans ,Propensity Score ,Carcinoma, Renal Cell ,Proportional Hazards Models ,Retrospective Studies ,Aged ,Neoplasm Staging ,business.industry ,Proportional hazards model ,Retrospective cohort study ,medicine.disease ,upstaging ,Multivariate Analysis ,Propensity score matching ,Proportional Hazards Model ,business - Abstract
Background: A non-negligible proportion of individuals diagnosed with cT1 renal cell carcinoma (RCC) are upstaged to pT3a at final pathology. Few data on oncological outcomes for these patients are available to determine whether partial nephrectomy (PN) might jeopardise cancer control. Objective: To assess, within an international multi-institutional collaboration, whether PN might undermine cancer control relative to radical nephrectomy (RN) in RCC patients with unexpected pT3a disease. Design, setting, and participants: International multi-institutional collaboration including patients with cT1abN0M0-pT3a RCC. Intervention: PN or RN. Outcome measurements and statistical analysis: We used Kaplan-Meier analyses, before and after propensity-score matching, to evaluate differences in metastatic progression (MP) and cancer-specific mortality (CSM) rates during follow-up. Univariable and multivariable Cox regression analyses were used to assess predictors of MP and CSM. Results and limitations: Overall, 309 patients with cT1abN0M0 RCC (cT1aN0M0, n = 107, 34.6%; cT1bN0M0, n = 202, 65.4%) had pT3a disease according to final pathology. Patients were treated with either PN (n = 71, 23%) or RN (n = 238, 77%). MP at 1, 2, and 5 yr was detected in 9.1%, 13.3%, and 24.1% of patients, respectively. CSM was 3.5%, 10.7%, and 18.4% at 1, 2, and 5 yr, respectively. After matching, no difference in terms of MP or CSM was observed between the PN and RN cohorts (both p>0.3). On multivariable analysis, type of surgery (PN vs RN) was not an independent predictor of either MP (p = 0.3) or CSM (p = 0.4). Limitations include the retrospective design. Conclusions: In patients with unexpected pT3a RCC at final pathology, PN does not appear to jeopardise cancer control with regard to MP and CSM. Patient summary: Cancer control is similar between patients treated with removal of the entire kidney and those with only partial removal, even if the final histology examination demonstrates a tumour that is unexpectedly not confined within the kidney. Partial nephrectomy does not undermine cancer control when unexpected pT3a renal cancer is identified at final pathology.
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- 2018
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6. Partial versus radical nephrectomy in very elderly patients: a propensity score analysis of surgical, functional and oncologic outcomes (RESURGE project)
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Kazunari Tanabe, Toshio Takagi, Ryan W. Dobbs, Maria Furlan, Gaelle Fiard, Matteo Ferro, Antonio Celia, Simone Crivellaro, Alberto Breda, Andrea Tubaro, Pierluigi Bove, Salvatore Micali, J. Torres, Paolo Umari, Ottavio De Cobelli, Alexandre Mottrie, Ali Abdel Raheem, Giulia Barbati, Umberto Capitanio, Francesco Porpiglia, Estefania Linares, Caterina Gregorio, Riccardo Autorino, Estevão Lima, Alessandro Antonelli, Bo Yang, Maria Carmen Mir, Tommaso Silvestri, Sisto Perdonà, Alfredo Aguilera, Thomas Amiel, Giuseppe Quarto, Jean Alexandre Long, Francesco Montorsi, Bernardino De Concilio, Zachary Hamilton, L. Bevilacqua, Ahmet Bindayi, Koon Ho Rha, Chao Zang, Carlotta Palumbo, Luigi Schips, Ithaar Derweesh, Nicola Pavan, Cosimo De Nunzio, Carlo Trombetta, Andrew Tracey, Joan Palou, Oscar Rodriguez-Faba, Roberto Castellucci, Christian Fiori, Alessandro Larcher, Tobias Maurer, Mir, Maria C, Pavan, Nicola, Capitanio, Umberto, Antonelli, Alessandro, Derweesh, Ithaar, Rodriguez-Faba, Oscar, Linares, Estefania, Takagi, Toshio, Rha, Koon H, Fiori, Christian, Maurer, Tobia, Zang, Chao, Mottrie, Alexandre, Umari, Paolo, Long, Jean-Alexandre, Fiard, Gaelle, De Nunzio, Cosimo, Tubaro, Andrea, Tracey, Andrew T, Ferro, Matteo, De Cobelli, Ottavio, Micali, Salvatore, Bevilacqua, Luigi, Torres, João, Schips, Luigi, Castellucci, Roberto, Dobbs, Ryan, Quarto, Giuseppe, Bove, Pierluigi, Celia, Antonio, De Concilio, Bernardino, Trombetta, Carlo, Silvestri, Tommaso, Larcher, Alessandro, Montorsi, Francesco, Palumbo, Carlotta, Furlan, Maria, Bindayi, Ahmet, Hamilton, Zachary, Breda, Alberto, Palou, Joan, Aguilera, Alfredo, Tanabe, Kazunari, Raheem, Ali, Amiel, Thoma, Yang, Bo, Lima, Estevão, Crivellaro, Simone, Perdona, Sisto, Gregorio, Caterina, Barbati, Giulia, Porpiglia, Francesco, Autorino, Riccardo, Mir, M. C., Pavan, N., Capitanio, U., Antonelli, A., Derweesh, I., Rodriguez-Faba, O., Linares, E., Takagi, T., Rha, K. H., Fiori, C., Maurer, T., Zang, C., Mottrie, A., Umari, P., Long, J. -A., Fiard, G., De Nunzio, C., Tubaro, A., Tracey, A. T., Ferro, M., De Cobelli, O., Micali, S., Bevilacqua, L., Torres, J., Schips, L., Castellucci, R., Dobbs, R., Quarto, G., Bove, P., Celia, A., De Concilio, B., Trombetta, C., Silvestri, T., Larcher, A., Montorsi, F., Palumbo, C., Furlan, M., Bindayi, A., Hamilton, Z., Breda, A., Palou, J., Aguilera, A., Tanabe, K., Raheem, A., Amiel, T., Yang, B., Lima, E., Crivellaro, S., Perdona, S., Gregorio, C., Barbati, G., Porpiglia, F., Autorino, R., Department of urology, Università Vita-Salute San Raffaele, OLVG Hospital, Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Department of Urology, Sant'Andrea Hospital - Sapienza University of Rome, Department of Clinical and Molecular Medicine, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], Medical University Graz, Cancer Prognostics and Health Outcomes Unit, Université de Montréal (UdeM), servicio de urologia, Fundación Puigvert, La Paz University Hospital, Institute of Information Engineering [Beijing] (IIE), Chinese Academy of Sciences [Beijing] (CAS), Department of Endocrinology and Medical Oncology, Genitourinary Cancer Section, and Università degli studi di Napoli Federico II
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Nephrology ,Male ,medicine.medical_specialty ,Asia ,Urology ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,030232 urology & nephrology ,Renal function ,Nephrectomy ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Elderly ,Interquartile range ,Internal medicine ,medicine ,Humans ,Partial nephrectomy ,Propensity Score ,Carcinoma, Renal Cell ,elderly ,kidney cancer ,nephrectomy ,partial nephrectomy ,Aged ,Neoplasm Staging ,Retrospective Studies ,business.industry ,Incidence ,Age Factors ,Retrospective cohort study ,Kidney cancer ,Middle Aged ,medicine.disease ,Kidney Neoplasms ,Europe ,Survival Rate ,Settore MED/24 ,Treatment Outcome ,030220 oncology & carcinogenesis ,Propensity score matching ,Cohort ,North America ,Female ,business ,Glomerular Filtration Rate - Abstract
International audience; PURPOSE:To compare the outcomes of PN to those of RN in very elderly patients treated for clinically localized renal tumor.PATIENTS AND METHODS:A purpose-built multi-institutional international database (RESURGE project) was used for this retrospective analysis. Patients over 75 years old and surgically treated for a suspicious of localized renal with either PN or RN were included in this database. Surgical, renal function and oncological outcomes were analyzed. Propensity scores for the predicted probability to receive PN in each patient were estimated by logistic regression models. Cox proportional hazard models were estimated to determine the relative change in hazard associated with PN vs RN on overall mortality (OM), cancer-specific mortality (CSM) and other-cause mortality (OCM).RESULTS:A total of 613 patients who underwent RN were successfully matched with 613 controls who underwent PN. Higher overall complication rate was recorded in the PN group (33% vs 25%; p = 0.01). Median follow-up for the entire cohort was 35 months (interquartile range [IQR] 13-63 months). There was a significant difference between RN and PN in median decline of eGFR (39% vs 17%; p
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- 2019
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