MP58-10 INSTITUTIONAL ANALYSIS OF TRIFECTA DEFINITIONS: 3D VIRTUAL MODELS PREDICT HIGHER RATES OF 'SUCCESSFUL' MINIMALLY INVASIVE PARTIAL NEPHRECTOMY

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP58-10 INSTITUTIONAL ANALYSIS OF TRIFECTA DEFINITIONS: 3D VIRTUAL MODELS PREDICT HIGHER RATES OF 'SUCCESSFUL' MINIMALLY INVASIVE PARTIAL NEPHRECTOMY Daniele Amparore, Angela Pecoraro, Federico Piramide, Enrico Checcucci, Sabrina De Cillis, Alberto Piana, Gabriele Volpi, Davide Zamengo, Alberto Quarà, Giovanni Busacca, Marco Colombo, Dalia Cidda, Cecilia Gatti, Michele Ortenzi, Martina Mandaletti, Michele Sica, Paolo Verri, Matteo Manfredi, Cristian Fiori, and Francesco Porpiglia Daniele AmparoreDaniele Amparore More articles by this author , Angela PecoraroAngela Pecoraro More articles by this author , Federico PiramideFederico Piramide More articles by this author , Enrico CheccucciEnrico Checcucci More articles by this author , Sabrina De CillisSabrina De Cillis More articles by this author , Alberto PianaAlberto Piana More articles by this author , Gabriele VolpiGabriele Volpi More articles by this author , Davide ZamengoDavide Zamengo More articles by this author , Alberto QuaràAlberto Quarà More articles by this author , Giovanni BusaccaGiovanni Busacca More articles by this author , Marco ColomboMarco Colombo More articles by this author , Dalia CiddaDalia Cidda More articles by this author , Cecilia GattiCecilia Gatti More articles by this author , Michele OrtenziMichele Ortenzi More articles by this author , Martina MandalettiMartina Mandaletti More articles by this author , Michele SicaMichele Sica More articles by this author , Paolo VerriPaolo Verri More articles by this author , Matteo ManfrediMatteo Manfredi More articles by this author , Cristian FioriCristian Fiori More articles by this author , and Francesco PorpigliaFrancesco Porpiglia More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003311.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: 3D virtual models (3DVMs) are nowadays under scrutiny to improve partial nephrectomy (PN) outcomes. Over the year, five different Trifecta definitions have been proposed to optimize the framing of “success” in the PN field. The aim of the present study was to analyze if the use of 3DVMs could impact the success rate of minimally-invasive PN, according to the currently available definitions of Trifecta. METHODS: At our Institution 250 cT1-2N0M0 renal masses patients treated with minimally-invasive PN were prospectively enrolled. Inclusion criteria were the availability of contrast-enhanced CT from which a 3DVM was obtained, baseline and postoperative serum creatinine, and eGFR. These patients were then compared with a control group of 710 patients who underwent minimally-invasive PN with the same renal function assessments, but without 3DVMs. Trifecta rate was defined for each of the currently available definitions, after stratification according to 3DVMs availability. Multivariable logistic regression (MLR) models were used to predict the trifecta achievement according to the different trifecta definitions. RESULTS: Overall, 960 patients met the inclusion criteria. Among the definitions, Trifecta rates ranged between 70.8% to 97.4% in the 3DVM group vs. 56.8% to 92.8% in the control group (all p values<0.05). 3DVMs showed better postoperative outcomes in terms of ΔeGFR, (-16.6% vs. -2.7%, p=0.03), postoperative complications (15%, vs 22.9%, p=0.002) and major complications (Clavien Dindo >3, 2.8% vs 5.6%, p=0.03). At MLR 3DVMs assistance independently predicted higher rates of successful PN across all the available definitions of Trifecta (OR: 2.7 p<0.001, OR:2.0 p=0.0008, OR:2.8 p=0.02, OR 2.0 p=0.003). CONCLUSIONS: There was large variability in the rates of Trifecta according to different definitions, but always in favor of those PN assisted by 3DVMs. Their availability was found to be the constant predictive factor of successful PN, with a 2-fold higher probability of achieving Trifecta regardless of the different definitions available in Literature and justifying their introduction in clinical practice. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e799 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniele Amparore More articles by this author Angela Pecoraro More articles by this author Federico Piramide More articles by this author Enrico Checcucci More articles by this author Sabrina De Cillis More articles by this author Alberto Piana More articles by this author Gabriele Volpi More articles by this author Davide Zamengo More articles by this author Alberto Quarà More articles by this author Giovanni Busacca More articles by this author Marco Colombo More articles by this author Dalia Cidda More articles by this author Cecilia Gatti More articles by this author Michele Ortenzi More articles by this author Martina Mandaletti More articles by this author Michele Sica More articles by this author Paolo Verri More articles by this author Matteo Manfredi More articles by this author Cristian Fiori More articles by this author Francesco Porpiglia More articles by this author Expand All Advertisement PDF downloadLoading ...