TORNA ALL’ELENCO

CT2 kidney cancer: Could be managed with an organ-sparing approach? in Anticancer Research

2017
AOU San Luigi di Orbassano

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (10)Vedi tutti...

Porpiglia F

Bertolo R

Amparore D


et alii...

Abstract

Introduction: A nephron-sparing approach is recommended by the guidelines when embarking in the surgical management of T1 renal masses. But a paucity of data is available in Literature about partial nephrectomy (PN) for clinically-staged T2 (cT2) renal masses. The aim of the study was to evaluate perioperative, pathological and early functional outcomes of laparoscopic PN for cT2 renal tumors. Materials and Methods: All patients who underwent Laparoscopic PN between 06/2000 and 06/2016 were included in the analysis and retrospectively evaluated. All the surgical procedures were performed by the same surgeon. Demographics variables (gender, age, BMI and comorbidities, as classified by Charlson's Comorbidity Index) were evaluated; preoperative variables (side, size and surgical complexity of the lesion as classified by PADUA score), perioperative variables (blood losses, intraand post-operative complications as classified by Clavien system) and hospital stay were considered. Concerning pathological variables, histology and positive surgical margins rate at final pathology were analyzed. Functional outcomes like serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) were evaluated preoperatively and at discharge. Results: 21 patients were included in the present study: 14 of them (66.6%) were males, median age was 56 years (IQR 54-60), mean BMI was 24.4+3.34 and median CCI 2 (IQR 1-3). Lesions were right-sided in 42.8% (9/21), with a mean size of 76.5+11.1 mm and a median PADUA score of 10 (IQR 9-11). Two patients (9.5%) had solitary kidney. Concerning perioperative variables mean operative time was 131.4+40.9 min, with mean blood losses of 259.5+212.1 ml. Mean ischemia time was 22.4+13.1 min, 19% (4/21) of the procedures were performed without clamping of renal artery. Intraoperative complications rate was 9.5% (2/21). The rate of postoperative complications was 23.8% (5/21), with Clavien >3 complications recorded in 1 patients only. Median hosp

Keywords

postoperative complication; peroperative complication; pathology; partial nephrectomy; organ; middle aged; male; kidney cancer; kidney artery; ischemia; human tissue; human; hospitalization; histology; gender; female; estimated glomerular filtration rate; creatinine blood level; controlled study; complication; comorbidity; clinical article; cancer size; body mass; bleeding; adult; preoperative evaluation; radical nephrectomy; sample size; solitary kidney; surgeon; surgery; surgical margin; surgical technique;