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Does tumor rupture during robot-assisted partial nephrectomy have an impact on mid-term tumor recurrences?

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20 lug 2023

Does tumor rupture during robot-assisted partial nephrectomy have an impact on mid-term tumor recurrences?'s Cover Image

Radiology and Oncology

Volume 57 (2023): Numero 3 (Settembre 2023)

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Categoria dell'articolo: Research Article

Pubblicato online: 20 lug 2023

Pagine: 348 - 355

Ricevuto: 19 apr 2023

Accettato: 23 mag 2023

DOI: https://doi.org/10.2478/raon-2023-0031

Parole chiave
enucleation, tumor recurrence, renal cell carcinoma, robot-assisted partial nephrectomy, tumor rupture, warm ischemia time

© 2023 Simon Hawlina et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

(A) Example of tumor rupture during enucleation of a renal tumor. (B) Tumor bed after the tumor was completely removed from healthy kidney parenchyma (intraoperative snapshots).

Patient and tumor characteristics in the no tumor rupture group and the tumor rupture group

	No tumor rupture (N = 86)	Tumor rupture (N = 14)	P value
Patients, n (%)
Male	59 (69)	9 (64)	0.8
Female	27 (31)	5 (36)
Age (years), median (IQR)	60 (52–67)	60 (49–68)	0.9
Tumor size (mm), median (IQR)	30 (23–40)	37 (30–48)	0.2
RENAL nephrometry score, median (IQR)^*	7 (5–8)	8 (6.25–9.75)	0.028
Laterality, n (%)
Right kidney	40 (47)	6 (43)	0.8
Left kidney	46 (53)	8 (57)
Tumor localization, n (%)
Upper third	24 (28)	5(36)	0.8
Middle third	34 (39)	5 (36)
Lower third	28 (33)	4 (28)
Preoperative CT/MRI, n (%)
Tumor	72 (84)	13 (93)	0.4
Cystic	14 (16)	1 (7)

Pathologic characteristics and oncologic outcome in the no tumor rupture group and the tumor rupture group

	No tumor rupture (N = 86), n (%)	Tumor rupture (N = 14), n (%)	P value
Histology			0.043
Benign	8 (9)	1 (7)
Oncocytoma	7 (8)	1 (7)
Clear cell RCC	44 (51)	2 (14)
Papillary RCC	15 (17)	8 (57)
Chromophobe RCC	5 (6)	1 (7)
Clear cell papillary RCC	4 (5)	0 (0)
Other types of RCC	3 (3)	1 (7)
WHO/ISUP grade (RCC)			0.6
1	21 (35)	2 (25)
2	35 (58)	6 (75)
3	4 (7)	0 (0)
Pathologic stage			0.4
1a	58 (82)	9 (75)
1b	9 (13)	2 (17)
2a	1 (1)	1 (8)
3	3 (4)	0 (0)
Positive surgical margins	1 (1)	0 (0)	0.7
Local or distant recurrence	0 (0)	0 (0)

Perioperative and postoperative outcomes in the no tumor rupture group and the tumor rupture group

	No tumor rupture (N = 86)	Tumor rupture (N = 14)	P value
Operative time (min), median (IQR)	140 (115–171)	147 (135–168)	0.4
WIT (min), median (IQR)	15 (12–19)	22 (15–25)	0.026
No clamping, n (%)	8 (9)	0 (0)
Length of stay after surgery (days), median (IQR)	3 (2–3)	3 (2–3)	0.8
Creatinine (μmol/L), median (IQR)
Preoperative	80 (73–94)	80 (77–87)	0.9
2 days after RAPN	80 (70–98)	80 (75–89)	0.6
Variation	1 (−7 to 7)	1 (−7 to 8)	0.7
Intraoperative EBL (mL), median (IQR)	20 (0–50)	50 (20–100)	0.13
Hemoglobin (g/L), median (IQR)
Preoperative	148 (140–155)	148 (144–152)	0.7
2 days after RAPN	125 (119–133)	125 (122–129)	0.8
Variation	22 (14–27)	25 (20–27)	0.6
Transfusions, n (%)	3 (3)	0
Major complications (Clavien-Dindo ≥ 3), n (%)	2 (2)	0
Conversions to radical nephrectomy, n (%)	2 (2)	0 (0)

Lingua:: Inglese

Frequenza di pubblicazione:: 4 volte all'anno
Argomenti della rivista:: Medicina, Medicina clinica, Medicina interna, Ematologia, Oncologia, Radiologia

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