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Purely Off-Clamp Laparoscopic Partial Nephrectomy Stands the Test of Time: 15 Years Functional and Oncologic Outcomes from a Single Center Experience

Authors :
Aldo Brassetti
Umberto Anceschi
Alfredo Maria Bove
Francesco Prata
Manuela Costantini
Mariaconsiglia Ferriero
Riccardo Mastroianni
Leonardo Misuraca
Gabriele Tuderti
Giulia Torregiani
Marco Covotta
Michele Gallucci
Giuseppe Simone
Source :
Current Oncology, Vol 30, Iss 1, Pp 1196-1205 (2023)
Publication Year :
2023
Publisher :
MDPI AG, 2023.

Abstract

Background: Nephron-sparing surgery represents the gold standard treatment for organ-confined renal tumors. We present 15-years of outcomes after off-clamp laparoscopic partial nephrectomy (ocLPN). Methods: a retrospective analysis was performed on patients who underwent ocLPN between May 2001 and December 2005. Baseline demographic, clinical, pathologic, surgical, functional and survival data were collected. The Kaplan–Meier method evaluated group-specific oncologic outcomes at 5, 10 and 15 years and the log rank test assessed differences between groups. The same analysis investigated the probabilities of developing a significant renal function impairment (sRFI) and achieving ROMeS. Cox analyses identified predictors of this latter tricomposite outcome. Results: We included 63 patients whose median tumor size was 3 cm (IQR:2–4). At 15 years, the chances of developing local recurrence, metachronous renal cancers or distant metastases were 2 ± 2%, 23 ± 6% and 17 ± 5%, respectively. Consequently, disease-free, cancer-specific and overall-survival probabilities were 68 ± 6%, 90 ± 4% and 72 ± 6%. MCRSS and UCISS well predicted oncologic outcomes. Overall, nine (14%) patients experienced an sRFI and 33 (52%) achieved ROMeS. Age (HR: 1.046; p = 0.033) and malignant histology (low-risk cancers HR: 3.233, p = 0.048) (intermediate/high risk cancers HR: 5.721, p = 0.023) were independent predictors of ROMeS non-achievement. Conclusions: At 15 years from ocLPN, most of patients will experience both excellent functional and oncologic outcomes.

Details

Language :
English
ISSN :
17187729 and 11980052
Volume :
30
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Current Oncology
Publication Type :
Academic Journal
Accession number :
edsdoj.32d95e8d07b142debc94e1ea8a2a2e0b
Document Type :
article
Full Text :
https://doi.org/10.3390/curroncol30010092