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KMID : 1001020210190030183
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Journal of Urologic Oncology
2021 Volume.19 No. 3 p.183 ~ p.192
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Perioperative and Oncological Outcomes of 1,002 Consecutive Patients With Localized Renal Cell Carcinoma Treated by Robotic Partial Nephrectomy at a Single Center
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Kim Tae-Jin
Chung Jae-Hoon
Sung Hyun-Hwan
Jeon Hwang-Gyun
Jeong Byong-Chang
Jeon Seong-Soo
Lee Hyun-Moo
Kang Min-Yong
Seo Seong-Il
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Abstract
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Purpose: To analyze and compare the results of robotic partial nephrectomy (RPN) at a single center with the previous large-scale studies in terms of perioperative and oncological out-comes.
Materials and Methods: We retrospectively evaluated 1,013 cases of RPN in our center data-base from December 2008 to August 2018. Total 11 cases were excluded in final analysis. We evaluated perioperative outcomes as the Trifecta achievement, which is defined as no positive surgical margin (PSM), no perioperative complications greater than Clavien-Dindo classification I and a warm ischemia time of <25 minutes. In addition, we analyzed pathological and onco-logical outcomes; recurrence, metastasis, all-cause deaths, cancer-specific deaths, and 5-year survival rates.
Results: In 1,002 cases, the Trifecta achievement was 61.1% (n=612). The postoperative com-plication was 18.4% (n=184) but most were grade 2 or less (14.9%, n=145). Ninety-three cases (9.28%) had benign and 907 cases (90.5%) had malignant pathologies. A local recurrence were 14 cases (1.54%) and distant metastasis were 20 cases (2.2%) during follow-up periods. All-cause death rate was 1.2% (n=11) and cancer-specific death rate was 0.2% (n=2). The median follow-up period was 39 months. A 5-year recurrence-free survival rate, cancer-specific survival rate, and overall survival rate were 95.2%, 99.7%, and 98.4%.
Conclusions: In summary, our data shows comparable perioperative outcomes to other large-scale studies of RPN in terms of the Trifecta achievement with similar baseline characteristics. In terms of oncological outcomes, there was lower rate of PSM and similar recurrence free survival rate.
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KEYWORD
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Nephron-sparing surgery, Robotic partial nephrectomy, Trifecta
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