MP28-20 ROBOT-ASSISTED RADICAL NEPHRECTOMY AND INFERIOR VENA CAVA LEVEL I-III THROMBECTOMY: PERIOPERATIVE AND MID-TERM ONCOLOGIC OUTCOMES

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You have accessJournal of UrologyCME1 Apr 2023MP28-20 ROBOT-ASSISTED RADICAL NEPHRECTOMY AND INFERIOR VENA CAVA LEVEL I-III THROMBECTOMY: PERIOPERATIVE AND MID-TERM ONCOLOGIC OUTCOMES Umberto Anceschi, Aldo Brassetti, Alfredo Maria Bove, Gabriele Tuderti, Mariaconsiglia Ferriero, Leonardo Misuraca, Riccardo Mastroianni, Manuela Costantini, Salvatore Guaglianone, Giovanni Cacciamani, Mihir Desai, Monish Aron, Inderbir Singh Gill, and Giuseppe Simone Umberto AnceschiUmberto Anceschi More articles by this author , Aldo BrassettiAldo Brassetti More articles by this author , Alfredo Maria BoveAlfredo Maria Bove More articles by this author , Gabriele TudertiGabriele Tuderti More articles by this author , Mariaconsiglia FerrieroMariaconsiglia Ferriero More articles by this author , Leonardo MisuracaLeonardo Misuraca More articles by this author , Riccardo MastroianniRiccardo Mastroianni More articles by this author , Manuela CostantiniManuela Costantini More articles by this author , Salvatore GuaglianoneSalvatore Guaglianone More articles by this author , Giovanni CacciamaniGiovanni Cacciamani More articles by this author , Mihir DesaiMihir Desai More articles by this author , Monish AronMonish Aron More articles by this author , Inderbir Singh GillInderbir Singh Gill More articles by this author , and Giuseppe SimoneGiuseppe Simone More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003256.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Few series of robot-assisted radical nephrectomy (RARN) with inferior vena cava tumor thrombectomy (IVCT) for renal cell carcinoma (RCC) with venous tumor thrombus (VTT) are available in literature, all with short-term oncologic outcomes. The aim of this study is to describe perioperative and long-term oncologic outcomes of RARN and IVCT performed at a single, high-volume centre. METHODS: Between January 2014 and October 2022, 37 consecutive patients underwent RARN-IVCT for RCC and VTT at a single tertiary-care center. Baseline, demographic and perioperative data were collected. A descriptive statistical analysis was performed. Frequencies and proportions were reported for categorical variables while medians and interquartile ranges (IQRs) were reported for continuously coded variables. Overall survival (OS), disease-free survival (DFS) and metastasis-free (MFS) were computed with the Kaplan-Meier method. RESULTS: Overall 37 consecutive patients were included in the analysis, 8 with VTT Mayo level I (21.6%), 11 with level II (29.7%), and 18 with level III (48.7%), respectively. All cases were successfully completed without conversion to open surgery. Median operative time was 360 minutes (IQR 232.5-382.5). Median estimated blood loss was 550 ml (IQR 275-1500). Median hospital stay was 7 days (IQR 4-12.2). Overall, 19 patients (51.3%) had perioperative complications, 15 Clavien grade 2 (40.5%, all blood transfusions) and 4 grade 3-5 (10.8%), respectively. At a median follow-up of 32 months (IQR 17.2-62.5), MFS, DFS and OS probabilities were 37.8%, 59.4%, and 59.4%, respectively. The small series, the high rate of adjuvant targeted therapies (32.4%) as the extreme surgical complexity may affect reproducibility of outcomes. CONCLUSIONS: RARN-IVCT represents a feasible and safe surgical option in tertiary referral centers; mid-term oncologic results seem to be comparable to those reported in open surgery literature. Our results support RARN-IVCT as a feasible and safe surgical option in tertiary referral centers even in the most advanced setting. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e379 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Umberto Anceschi More articles by this author Aldo Brassetti More articles by this author Alfredo Maria Bove More articles by this author Gabriele Tuderti More articles by this author Mariaconsiglia Ferriero More articles by this author Leonardo Misuraca More articles by this author Riccardo Mastroianni More articles by this author Manuela Costantini More articles by this author Salvatore Guaglianone More articles by this author Giovanni Cacciamani More articles by this author Mihir Desai More articles by this author Monish Aron More articles by this author Inderbir Singh Gill More articles by this author Giuseppe Simone More articles by this author Expand All Advertisement PDF downloadLoading ...