MP63-10 MINIMUM 5 YEAR FOLLOW-UP AFTER ROBOTIC PARTIAL NEPHRECTOMY : A MULTI-INSTITUTIONAL ANALYSIS

Abstract

You have accessJournal of UrologyKidney Cancer: Surgical Therapy IV1 Apr 2015MP63-10 MINIMUM 5 YEAR FOLLOW-UP AFTER ROBOTIC PARTIAL NEPHRECTOMY : A MULTI-INSTITUTIONAL ANALYSIS Homayoun Zargar, Mohamad Allaf, Craig Rogers, Michael Stifelman, Sam Bhayani, Alon Mass, Ravi Barod, Michael H. Johnson, Jeffrey A. Larson, and Jihad H. Kaouk Homayoun ZargarHomayoun Zargar More articles by this author , Mohamad AllafMohamad Allaf More articles by this author , Craig RogersCraig Rogers More articles by this author , Michael StifelmanMichael Stifelman More articles by this author , Sam BhayaniSam Bhayani More articles by this author , Alon MassAlon Mass More articles by this author , Ravi BarodRavi Barod More articles by this author , Michael H. JohnsonMichael H. Johnson More articles by this author , Jeffrey A. LarsonJeffrey A. Larson More articles by this author , and Jihad H. KaoukJihad H. Kaouk More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2342AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The utility of robotic partial nephrectomy (RPN) for the treatment of renal masses has increased in recent years. Although short to intermediate term functional and oncological data have been promising but long term data in this setting is sparse. The aim of the current study was to report the long-term outcomes of RPN in a multi-institutional cohort of patients who underwent the procedure at least 5 years ago. METHODS We retrospectively reviewed the records of 1836 cases of RPN performed in 5 high volume centres across USA from 2007 to mid 2014. We limited our study to cases where RPN was performed at least 5 years prior. Local recurrence, metastasis rate, overall survival (OS) and cancer specific survival (CSS) were assessed. Time from surgery was calculated from the time of study (November 2014) to the date of surgery. Actual follow up time was assessed as the time between latest follow up time and the date of surgery. GFR preservation was calculated as proportion of latest GFR to preoperative GFR. RESULTS Total of 369 patients met our inclusion criteria. The median time from the RPN surgery was 5 years (IQR 5-6). The median age of the cohort was 60.9 years and the median tumor nephrometry score was 7 (IQR 5-8). The median actual follow up time was 54.8 months (IQR 25.1-62.5). For the 274 patients with renal cell carcinoma the local recurrence and metastasis rates were 3.6 and 1.5% respectively. The OS and CSS were 94.2 and 98.9% respectively. The median time to latest renal function assessment was 51 months (IQR 23.5-60) with median GFR preservation of 89.6% (77.2-104). On multivariable cox regression model for identifying factors predicting overall mortality (age, comorbidities, pre-operative GFR, proportion of GFR preservation, tumor stage and surgical margin) positive surgical margin was a strong predictor of overall mortality (HR =38 (95% CI (3-474); p=0.005). CONCLUSIONS RPN in carefully selected cohort of patients provides excellent long-term oncological and functional outcomes. Positive surgical margin was a predictor of overall mortality in our series. Our results need to be validated by other RPN series as the follow up data further matures. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e792 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Homayoun Zargar More articles by this author Mohamad Allaf More articles by this author Craig Rogers More articles by this author Michael Stifelman More articles by this author Sam Bhayani More articles by this author Alon Mass More articles by this author Ravi Barod More articles by this author Michael H. Johnson More articles by this author Jeffrey A. Larson More articles by this author Jihad H. Kaouk More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...