INTRODUCTION: Nephron-sparing surgery (NSS) has become the standard of care for the surgical management of small and clinically localized renal cell carcinoma (RCC). The conservative management of those RCCs is increasing over time. Aim of this study was to report a snapshot of the clinical, perioperative and oncological results after NSS for RCC in Italy. MATERIAL AND METHODS: We evaluated all patients who underwent conservative surgical treatment for renal tumours between January 2009 and December 2012 at 19 urological Italian Centers (RECORd project). Perioperative, radiological and histopathological data were recorded. Surgical eras (2009 vs 2012 and year periods 2009-2010 vs 2011-2012) were compared. RESULTS: Globally, 983 patients were evaluated. More recently, patients undergoing NSS were found to be significantly younger (p = 0.05) than those surgically treated in the first study period, with a significantly higher rate of NSS with relative and imperative indication (p < 0.001). More recently, a higher percentage of procedures for cT1b or cT2 renal tumours was observed (p = 0.02). Utilization rate of open partial nephrectomy (OPN) constantly decreased during years, laparoscopic partial nephrectomy (LPN) remained almost constant while robot-assisted partial nephrectomy (RAPN) increased. The rate of clampless NSS constantly increased over time. The use of at least one haemostatic agent has been significantly more adopted in the most recent surgical era (p < 0.001). CONCLUSIONS: The utilization rate of NSS in Italy is increasing, even in elective and more complex cases. RAPN has been progressively adopted, as well as the intraoperative utilization of haemostatic agents and the rate of clampless procedures.

A snapshot of nephron-sparing surgery in Italy: A prospective, multicenter report on clinical and perioperative outcomes (the RECORd 1 project) / Schiavina, R.; Mari, A.; Antonelli, A.; Bertolo, R.; Bianchi, Giampaolo; Borghesi, M.; Brunocilla, E.; Fiori, C.; Longo, N.; Martorana, G.; Mirone, V.; Morgia, G.; Novara, G.; Porpiglia, F.; Rovereto, B.; Serni, S.; Simeone, C.; Sodano, M.; Terrone, C.; Carini, M.; Minervini, A.. - In: EUROPEAN JOURNAL OF SURGICAL ONCOLOGY. - ISSN 0748-7983. - STAMPA. - 41:3(2015), pp. 346-352. [10.1016/j.ejso.2014.12.001]

A snapshot of nephron-sparing surgery in Italy: A prospective, multicenter report on clinical and perioperative outcomes (the RECORd 1 project)

BIANCHI, Giampaolo;
2015

Abstract

INTRODUCTION: Nephron-sparing surgery (NSS) has become the standard of care for the surgical management of small and clinically localized renal cell carcinoma (RCC). The conservative management of those RCCs is increasing over time. Aim of this study was to report a snapshot of the clinical, perioperative and oncological results after NSS for RCC in Italy. MATERIAL AND METHODS: We evaluated all patients who underwent conservative surgical treatment for renal tumours between January 2009 and December 2012 at 19 urological Italian Centers (RECORd project). Perioperative, radiological and histopathological data were recorded. Surgical eras (2009 vs 2012 and year periods 2009-2010 vs 2011-2012) were compared. RESULTS: Globally, 983 patients were evaluated. More recently, patients undergoing NSS were found to be significantly younger (p = 0.05) than those surgically treated in the first study period, with a significantly higher rate of NSS with relative and imperative indication (p < 0.001). More recently, a higher percentage of procedures for cT1b or cT2 renal tumours was observed (p = 0.02). Utilization rate of open partial nephrectomy (OPN) constantly decreased during years, laparoscopic partial nephrectomy (LPN) remained almost constant while robot-assisted partial nephrectomy (RAPN) increased. The rate of clampless NSS constantly increased over time. The use of at least one haemostatic agent has been significantly more adopted in the most recent surgical era (p < 0.001). CONCLUSIONS: The utilization rate of NSS in Italy is increasing, even in elective and more complex cases. RAPN has been progressively adopted, as well as the intraoperative utilization of haemostatic agents and the rate of clampless procedures.
2015
27-dic-2014
41
3
346
352
A snapshot of nephron-sparing surgery in Italy: A prospective, multicenter report on clinical and perioperative outcomes (the RECORd 1 project) / Schiavina, R.; Mari, A.; Antonelli, A.; Bertolo, R.; Bianchi, Giampaolo; Borghesi, M.; Brunocilla, E.; Fiori, C.; Longo, N.; Martorana, G.; Mirone, V.; Morgia, G.; Novara, G.; Porpiglia, F.; Rovereto, B.; Serni, S.; Simeone, C.; Sodano, M.; Terrone, C.; Carini, M.; Minervini, A.. - In: EUROPEAN JOURNAL OF SURGICAL ONCOLOGY. - ISSN 0748-7983. - STAMPA. - 41:3(2015), pp. 346-352. [10.1016/j.ejso.2014.12.001]
Schiavina, R.; Mari, A.; Antonelli, A.; Bertolo, R.; Bianchi, Giampaolo; Borghesi, M.; Brunocilla, E.; Fiori, C.; Longo, N.; Martorana, G.; Mirone, V.; Morgia, G.; Novara, G.; Porpiglia, F.; Rovereto, B.; Serni, S.; Simeone, C.; Sodano, M.; Terrone, C.; Carini, M.; Minervini, A.
File in questo prodotto:
File Dimensione Formato  
a snapshot.pdf

Accesso riservato

Tipologia: Versione pubblicata dall'editore
Dimensione 684.51 kB
Formato Adobe PDF
684.51 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1080116
Citazioni
  • ???jsp.display-item.citation.pmc??? 11
  • Scopus 40
  • ???jsp.display-item.citation.isi??? 39
social impact