PD07-04 OFF-CLAMP ROBOTIC PARTIAL NEPHRECTOMY: 10-YEAR SURVIVAL AND FUNCTIONAL OUTCOMES FROM A HIGH-VOLUME SINGLE CENTER SERIES

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD07-04 OFF-CLAMP ROBOTIC PARTIAL NEPHRECTOMY: 10-YEAR SURVIVAL AND FUNCTIONAL OUTCOMES FROM A HIGH-VOLUME SINGLE CENTER SERIES Gabriele Tuderti, Riccardo Mastroianni, Umberto Anceschi, Simone D'Annunzio, Alfredo Maria Bove, Aldo Brassetti, Mariaconsiglia Ferriero, Leonardo Misuraca, Salvatore Guaglianone, Michele Gallucci, and Giuseppe Simone Gabriele TudertiGabriele Tuderti More articles by this author , Riccardo MastroianniRiccardo Mastroianni More articles by this author , Umberto AnceschiUmberto Anceschi More articles by this author , Simone D'AnnunzioSimone D'Annunzio More articles by this author , Alfredo Maria BoveAlfredo Maria Bove More articles by this author , Aldo BrassettiAldo Brassetti More articles by this author , Mariaconsiglia FerrieroMariaconsiglia Ferriero More articles by this author , Leonardo MisuracaLeonardo Misuraca More articles by this author , Salvatore GuaglianoneSalvatore Guaglianone More articles by this author , Michele GallucciMichele Gallucci More articles by this author , and Giuseppe SimoneGiuseppe Simone More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003231.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The adoption of Off-clamp (Off-C) robotic partial nephrectomy (RPN) is led by the intent to maximize renal functional preservation. There is paucity of evidences about long-term functional outcomes of Off-c RPN. The aim of this study was to report peri-operative, and long term functional and survival outcomes of a single high-volume center series of Off-C RPN. METHODS: A prospective renal cancer institutional database was queried, and data of consecutive patients treated with Off-C RPN between 2010 and 2015 in a high-volume center were collected. Baseline, preoperative, perioperative, oncological and functional outcomes were assessed. Trifecta was defined as the coexistence of negative margins, no Clavien-Dindo ≥3 complications and ≤30% postoperative estimated glomerular filtration rate reduction. Kaplan-Meier analysis was performed to assess survival and renal functional outcomes. Univariable and multivariable analyses were carried out to identify predictors of Trifecta achievement and renal function deterioration over time. RESULTS: Overall, 530 patients with a mean follow-up of 57.8 months were included. Severe perioperative complications occured in 1.9% of patients. Trifecta was achieved in 80.9% of cases. The 8-year recurrence-free survival, cancer-specific survival and overall survival rates were 96.8%, 99% and 96.4%, respectively. Patients with baseline eGFR ≥60 ml/min displayed a negligible risk of long term severe renal function deterioration (10-yr newly onset Chronic kidney disease (CKD) stage 3b risk: 8.1% for patients with preop CKD stage 1, 4.9% for patients with preop CKD stage 2). At multivariable analysis, the increasing tumor complexity (PADUA score) was the only indipendent predictor of Trifecta achievement reduction. Concerning functional outcomes, age at surgery was the only independent predictor of developing newly-onset CKD stage≥3b (HR 1.10, 95% CI 1.009-1.19–0.98;p=0.03). CONCLUSIONS: Off-C RPN represents a safe surgical approach with a negligible risk of severe perioperative complications occurrence. With regard to functional outcomes, at 10-yr evaluation renal function deterioration is mainly driven by patients ageing. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e162 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Gabriele Tuderti More articles by this author Riccardo Mastroianni More articles by this author Umberto Anceschi More articles by this author Simone D'Annunzio More articles by this author Alfredo Maria Bove More articles by this author Aldo Brassetti More articles by this author Mariaconsiglia Ferriero More articles by this author Leonardo Misuraca More articles by this author Salvatore Guaglianone More articles by this author Michele Gallucci More articles by this author Giuseppe Simone More articles by this author Expand All Advertisement PDF downloadLoading ...