American Confederation of Urology (CAU) experience in minimally invasive partial nephrectomy

Fernando P. Secin, Octavio A. Castillo, José J. Rozanec, Marcelo Featherston, Pablo Holst, José Cocisfran Alves Milfont, Patricio García Marchiñena, Alberto Jurado Navarro, Anamaría Autrán, Agustín R. Rovegno, Oscar Rodríguez Faba, Joan Palou, Victor Teixeira Dubeux, Luciano Nuñez Bragayrac, Rene Sotelo, Stenio Zequi, Gustavo Cardoso Guimarães, Mario Álvarez-Maestro, Luis Martínez-Piñeiro, Gustavo Villoldo & 14 otros Alberto Villaronga, Diego Abreu Clavijo, Ricardo Decia, Rodrigo Frota, Ivar Vidal-Mora, Diana Finkelstein, Juan I. Monzó Gardiner, Oscar Schatloff, Andres Hernández-Porrás, Félix Santaella-Torres, Emilio T. Quesada, Rodolfo Sánchez-Salas, Hugo Dávila, Humberto Villavicencio Mavric

Resultado de la investigación: Contribución a la publicaciónArticle

Resumen

Purpose: To describe the perioperative and oncology outcomes in a series of laparoscopic or robotic partial nephrectomies (PN) for renal tumors treated in diverse institutions of Hispanic America from the beginning of their minimally invasive (MI) PN experience through December 2014. Methods: Seventeen institutions participated in the CAU generated a MI PN database. We estimated proportions, medians, 95 % confidence intervals, Kaplan–Meier curves, multivariate logistic and Cox regression analyses. Clavien–Dindo classification was used. Results: We evaluated 1501 laparoscopic (98 %) or robotic (2 %) PNs. Median age: 58 years. Median surgical time, warm ischemia and intraoperative bleeding were 150, 20 min and 200 cc. 81 % of the lesions were malignant, with clear cell histology being 65 % of the total. Median maximum tumor diameter is 2.7 cm, positive margin is 8.2 %, and median hospitalization is 3 days. One or more postoperative complication was recorded in 19.8 % of the patients: Clavien 1: 5.6 %; Clavien 2: 8.4 %; Clavien 3A: 1.5 %; Clavien 3B: 3.2 %; Clavien 4A: 1 %; Clavien 4B: 0.1 %; Clavien 5: 0 %. Bleeding was the main cause of a reoperation (5.5 %), conversion to radical nephrectomy (3 %) or open partial nephrectomy (6 %). Transfusion rate is 10 %. In multivariate analysis, RENAL nephrometry score was the only variable associated with complications (OR 1.1; 95 % CI 1.02–1.2; p = 0.02). Nineteen patients presented disease progression or died of disease in a median follow-up of 1.37 years. The 5-year progression or kidney cancer mortality-free rate was 94 % (95 % CI 90, 97). Positive margins (HR 4.98; 95 % CI 1.3–19; p = 0.02) and females (HR 5.6; 95 % CI 1.7–19; p = 0.005) were associated with disease progression or kidney cancer mortality after adjusting for maximum tumor diameter. Conclusion: Laparoscopic PN in these centers of Hispanic America seem to have acceptable perioperative complications and short-term oncologic outcomes.

Idioma originalEnglish
Páginas (desde - hasta)57-65
Número de páginas9
PublicaciónWorld Journal of Urology
Volumen35
Número de edición1
Identificadores de objetos digitales
EstadoPublished - 1 ene 2017
Publicado de forma externa

Huella dactilar

Urology
Nephrectomy
Neoplasms
Kidney Neoplasms
Robotics
Hispanic Americans
Disease Progression
Hemorrhage
Mortality
Operative Time
Reoperation
Histology
Hospitalization
Multivariate Analysis
Logistic Models
Regression Analysis
Confidence Intervals
Kidney

Keywords

    ASJC Scopus subject areas

    • Urology

    Citar esto

    Secin, F. P., Castillo, O. A., Rozanec, J. J., Featherston, M., Holst, P., Milfont, J. C. A., ... Mavric, H. V. (2017). American Confederation of Urology (CAU) experience in minimally invasive partial nephrectomy. World Journal of Urology, 35(1), 57-65. DOI: 10.1007/s00345-016-1837-z

    Secin, Fernando P.; Castillo, Octavio A.; Rozanec, José J.; Featherston, Marcelo; Holst, Pablo; Milfont, José Cocisfran Alves; García Marchiñena, Patricio; Jurado Navarro, Alberto; Autrán, Anamaría; Rovegno, Agustín R.; Faba, Oscar Rodríguez; Palou, Joan; Teixeira Dubeux, Victor; Nuñez Bragayrac, Luciano; Sotelo, Rene; Zequi, Stenio; Guimarães, Gustavo Cardoso; Álvarez-Maestro, Mario; Martínez-Piñeiro, Luis; Villoldo, Gustavo; Villaronga, Alberto; Abreu Clavijo, Diego; Decia, Ricardo; Frota, Rodrigo; Vidal-Mora, Ivar; Finkelstein, Diana; Monzó Gardiner, Juan I.; Schatloff, Oscar; Hernández-Porrás, Andres; Santaella-Torres, Félix; Quesada, Emilio T.; Sánchez-Salas, Rodolfo; Dávila, Hugo; Mavric, Humberto Villavicencio / American Confederation of Urology (CAU) experience in minimally invasive partial nephrectomy.

    En: World Journal of Urology, Vol. 35, N.º 1, 01.01.2017, p. 57-65.

    Resultado de la investigación: Contribución a la publicaciónArticle

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    title = "American Confederation of Urology (CAU) experience in minimally invasive partial nephrectomy",
    abstract = "Purpose: To describe the perioperative and oncology outcomes in a series of laparoscopic or robotic partial nephrectomies (PN) for renal tumors treated in diverse institutions of Hispanic America from the beginning of their minimally invasive (MI) PN experience through December 2014. Methods: Seventeen institutions participated in the CAU generated a MI PN database. We estimated proportions, medians, 95 % confidence intervals, Kaplan–Meier curves, multivariate logistic and Cox regression analyses. Clavien–Dindo classification was used. Results: We evaluated 1501 laparoscopic (98 %) or robotic (2 %) PNs. Median age: 58 years. Median surgical time, warm ischemia and intraoperative bleeding were 150, 20 min and 200 cc. 81 % of the lesions were malignant, with clear cell histology being 65 % of the total. Median maximum tumor diameter is 2.7 cm, positive margin is 8.2 %, and median hospitalization is 3 days. One or more postoperative complication was recorded in 19.8 % of the patients: Clavien 1: 5.6 %; Clavien 2: 8.4 %; Clavien 3A: 1.5 %; Clavien 3B: 3.2 %; Clavien 4A: 1 %; Clavien 4B: 0.1 %; Clavien 5: 0 %. Bleeding was the main cause of a reoperation (5.5 %), conversion to radical nephrectomy (3 %) or open partial nephrectomy (6 %). Transfusion rate is 10 %. In multivariate analysis, RENAL nephrometry score was the only variable associated with complications (OR 1.1; 95 % CI 1.02–1.2; p = 0.02). Nineteen patients presented disease progression or died of disease in a median follow-up of 1.37 years. The 5-year progression or kidney cancer mortality-free rate was 94 % (95 % CI 90, 97). Positive margins (HR 4.98; 95 % CI 1.3–19; p = 0.02) and females (HR 5.6; 95 % CI 1.7–19; p = 0.005) were associated with disease progression or kidney cancer mortality after adjusting for maximum tumor diameter. Conclusion: Laparoscopic PN in these centers of Hispanic America seem to have acceptable perioperative complications and short-term oncologic outcomes.",
    keywords = "Kidney cancer, Laparoscopy, Nephron sparing, Partial nephrectomy",
    author = "Secin, {Fernando P.} and Castillo, {Octavio A.} and Rozanec, {José J.} and Marcelo Featherston and Pablo Holst and Milfont, {José Cocisfran Alves} and {García Marchiñena}, Patricio and {Jurado Navarro}, Alberto and Anamaría Autrán and Rovegno, {Agustín R.} and Faba, {Oscar Rodríguez} and Joan Palou and {Teixeira Dubeux}, Victor and {Nuñez Bragayrac}, Luciano and Rene Sotelo and Stenio Zequi and Guimarães, {Gustavo Cardoso} and Mario Álvarez-Maestro and Luis Martínez-Piñeiro and Gustavo Villoldo and Alberto Villaronga and {Abreu Clavijo}, Diego and Ricardo Decia and Rodrigo Frota and Ivar Vidal-Mora and Diana Finkelstein and {Monzó Gardiner}, {Juan I.} and Oscar Schatloff and Andres Hernández-Porrás and Félix Santaella-Torres and Quesada, {Emilio T.} and Rodolfo Sánchez-Salas and Hugo Dávila and Mavric, {Humberto Villavicencio}",
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    month = "1",
    doi = "10.1007/s00345-016-1837-z",
    volume = "35",
    pages = "57--65",
    journal = "World Journal of Urology",
    issn = "0724-4983",
    publisher = "Springer Verlag",
    number = "1",

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    Secin, FP, Castillo, OA, Rozanec, JJ, Featherston, M, Holst, P, Milfont, JCA, García Marchiñena, P, Jurado Navarro, A, Autrán, A, Rovegno, AR, Faba, OR, Palou, J, Teixeira Dubeux, V, Nuñez Bragayrac, L, Sotelo, R, Zequi, S, Guimarães, GC, Álvarez-Maestro, M, Martínez-Piñeiro, L, Villoldo, G, Villaronga, A, Abreu Clavijo, D, Decia, R, Frota, R, Vidal-Mora, I, Finkelstein, D, Monzó Gardiner, JI, Schatloff, O, Hernández-Porrás, A, Santaella-Torres, F, Quesada, ET, Sánchez-Salas, R, Dávila, H & Mavric, HV 2017, 'American Confederation of Urology (CAU) experience in minimally invasive partial nephrectomy' World Journal of Urology, vol. 35, n.º 1, pp. 57-65. DOI: 10.1007/s00345-016-1837-z

    American Confederation of Urology (CAU) experience in minimally invasive partial nephrectomy. / Secin, Fernando P.; Castillo, Octavio A.; Rozanec, José J.; Featherston, Marcelo; Holst, Pablo; Milfont, José Cocisfran Alves; García Marchiñena, Patricio; Jurado Navarro, Alberto; Autrán, Anamaría; Rovegno, Agustín R.; Faba, Oscar Rodríguez; Palou, Joan; Teixeira Dubeux, Victor; Nuñez Bragayrac, Luciano; Sotelo, Rene; Zequi, Stenio; Guimarães, Gustavo Cardoso; Álvarez-Maestro, Mario; Martínez-Piñeiro, Luis; Villoldo, Gustavo; Villaronga, Alberto; Abreu Clavijo, Diego; Decia, Ricardo; Frota, Rodrigo; Vidal-Mora, Ivar; Finkelstein, Diana; Monzó Gardiner, Juan I.; Schatloff, Oscar; Hernández-Porrás, Andres; Santaella-Torres, Félix; Quesada, Emilio T.; Sánchez-Salas, Rodolfo; Dávila, Hugo; Mavric, Humberto Villavicencio.

    En: World Journal of Urology, Vol. 35, N.º 1, 01.01.2017, p. 57-65.

    Resultado de la investigación: Contribución a la publicaciónArticle

    TY - JOUR

    T1 - American Confederation of Urology (CAU) experience in minimally invasive partial nephrectomy

    AU - Secin,Fernando P.

    AU - Castillo,Octavio A.

    AU - Rozanec,José J.

    AU - Featherston,Marcelo

    AU - Holst,Pablo

    AU - Milfont,José Cocisfran Alves

    AU - García Marchiñena,Patricio

    AU - Jurado Navarro,Alberto

    AU - Autrán,Anamaría

    AU - Rovegno,Agustín R.

    AU - Faba,Oscar Rodríguez

    AU - Palou,Joan

    AU - Teixeira Dubeux,Victor

    AU - Nuñez Bragayrac,Luciano

    AU - Sotelo,Rene

    AU - Zequi,Stenio

    AU - Guimarães,Gustavo Cardoso

    AU - Álvarez-Maestro,Mario

    AU - Martínez-Piñeiro,Luis

    AU - Villoldo,Gustavo

    AU - Villaronga,Alberto

    AU - Abreu Clavijo,Diego

    AU - Decia,Ricardo

    AU - Frota,Rodrigo

    AU - Vidal-Mora,Ivar

    AU - Finkelstein,Diana

    AU - Monzó Gardiner,Juan I.

    AU - Schatloff,Oscar

    AU - Hernández-Porrás,Andres

    AU - Santaella-Torres,Félix

    AU - Quesada,Emilio T.

    AU - Sánchez-Salas,Rodolfo

    AU - Dávila,Hugo

    AU - Mavric,Humberto Villavicencio

    PY - 2017/1/1

    Y1 - 2017/1/1

    N2 - Purpose: To describe the perioperative and oncology outcomes in a series of laparoscopic or robotic partial nephrectomies (PN) for renal tumors treated in diverse institutions of Hispanic America from the beginning of their minimally invasive (MI) PN experience through December 2014. Methods: Seventeen institutions participated in the CAU generated a MI PN database. We estimated proportions, medians, 95 % confidence intervals, Kaplan–Meier curves, multivariate logistic and Cox regression analyses. Clavien–Dindo classification was used. Results: We evaluated 1501 laparoscopic (98 %) or robotic (2 %) PNs. Median age: 58 years. Median surgical time, warm ischemia and intraoperative bleeding were 150, 20 min and 200 cc. 81 % of the lesions were malignant, with clear cell histology being 65 % of the total. Median maximum tumor diameter is 2.7 cm, positive margin is 8.2 %, and median hospitalization is 3 days. One or more postoperative complication was recorded in 19.8 % of the patients: Clavien 1: 5.6 %; Clavien 2: 8.4 %; Clavien 3A: 1.5 %; Clavien 3B: 3.2 %; Clavien 4A: 1 %; Clavien 4B: 0.1 %; Clavien 5: 0 %. Bleeding was the main cause of a reoperation (5.5 %), conversion to radical nephrectomy (3 %) or open partial nephrectomy (6 %). Transfusion rate is 10 %. In multivariate analysis, RENAL nephrometry score was the only variable associated with complications (OR 1.1; 95 % CI 1.02–1.2; p = 0.02). Nineteen patients presented disease progression or died of disease in a median follow-up of 1.37 years. The 5-year progression or kidney cancer mortality-free rate was 94 % (95 % CI 90, 97). Positive margins (HR 4.98; 95 % CI 1.3–19; p = 0.02) and females (HR 5.6; 95 % CI 1.7–19; p = 0.005) were associated with disease progression or kidney cancer mortality after adjusting for maximum tumor diameter. Conclusion: Laparoscopic PN in these centers of Hispanic America seem to have acceptable perioperative complications and short-term oncologic outcomes.

    AB - Purpose: To describe the perioperative and oncology outcomes in a series of laparoscopic or robotic partial nephrectomies (PN) for renal tumors treated in diverse institutions of Hispanic America from the beginning of their minimally invasive (MI) PN experience through December 2014. Methods: Seventeen institutions participated in the CAU generated a MI PN database. We estimated proportions, medians, 95 % confidence intervals, Kaplan–Meier curves, multivariate logistic and Cox regression analyses. Clavien–Dindo classification was used. Results: We evaluated 1501 laparoscopic (98 %) or robotic (2 %) PNs. Median age: 58 years. Median surgical time, warm ischemia and intraoperative bleeding were 150, 20 min and 200 cc. 81 % of the lesions were malignant, with clear cell histology being 65 % of the total. Median maximum tumor diameter is 2.7 cm, positive margin is 8.2 %, and median hospitalization is 3 days. One or more postoperative complication was recorded in 19.8 % of the patients: Clavien 1: 5.6 %; Clavien 2: 8.4 %; Clavien 3A: 1.5 %; Clavien 3B: 3.2 %; Clavien 4A: 1 %; Clavien 4B: 0.1 %; Clavien 5: 0 %. Bleeding was the main cause of a reoperation (5.5 %), conversion to radical nephrectomy (3 %) or open partial nephrectomy (6 %). Transfusion rate is 10 %. In multivariate analysis, RENAL nephrometry score was the only variable associated with complications (OR 1.1; 95 % CI 1.02–1.2; p = 0.02). Nineteen patients presented disease progression or died of disease in a median follow-up of 1.37 years. The 5-year progression or kidney cancer mortality-free rate was 94 % (95 % CI 90, 97). Positive margins (HR 4.98; 95 % CI 1.3–19; p = 0.02) and females (HR 5.6; 95 % CI 1.7–19; p = 0.005) were associated with disease progression or kidney cancer mortality after adjusting for maximum tumor diameter. Conclusion: Laparoscopic PN in these centers of Hispanic America seem to have acceptable perioperative complications and short-term oncologic outcomes.

    KW - Kidney cancer

    KW - Laparoscopy

    KW - Nephron sparing

    KW - Partial nephrectomy

    UR - http://www.scopus.com/inward/record.url?scp=84965031390&partnerID=8YFLogxK

    U2 - 10.1007/s00345-016-1837-z

    DO - 10.1007/s00345-016-1837-z

    M3 - Article

    VL - 35

    SP - 57

    EP - 65

    JO - World Journal of Urology

    T2 - World Journal of Urology

    JF - World Journal of Urology

    SN - 0724-4983

    IS - 1

    ER -

    Secin FP, Castillo OA, Rozanec JJ, Featherston M, Holst P, Milfont JCA y otros. American Confederation of Urology (CAU) experience in minimally invasive partial nephrectomy. World Journal of Urology. 2017 ene 1;35(1):57-65. Disponible desde, DOI: 10.1007/s00345-016-1837-z