Partial nephrectomy in elderly patients provides quality outcomes as measured by trifecta. Tumor complexity is a key determinant for trifecta achievement, and trifecta attainment is associated with improved function. Increasing utilization of robotics has benefits in recovery without compromising quality._Partial nephrectomy (PN) in elderly patients is underutilized with concerns regarding risk of complications and potential for poor outcomes. Objective_ To evaluate quality and functional outcomes of PN in patients _75 yr using trifecta as a composite outcome of surgical quality. Design, setting, and participants_ Multicenter retrospective analysis of 653 patients aged _75 yr who underwent PN (REnal SURGery in Elderly [RESURGE] Group). Intervention_ PN. Outcome measurements and statistical analysis_ Primary outcome was achievement of trifecta (negative margin, no major [Clavien ≥3] urological complications, and ≥90% estimated glomerular filtration rate [eGFR] recovery). Secondary outcomes included chronic kidney disease (CKD) stage III and CKD upstaging. Multivariable analysis (MVA) was used to assess variables for achieving trifecta and functional outcomes. Kaplan-Meier survival analysis (KMA) was used to calculate renal functional outcomes. Results and limitations_ We analyzed 653 patients (mean age 78.4 yr, median follow-up 33 mo
Trifecta outcomes of partial nephrectomy in patients over 75 years old. Analysis of the renal surgery in elderly (RESURGE) group / Bindayi, A.; Autorino, R.; Capitanio, U.; Pavan, N.; Mir, M. C.; Antonelli, A.; Takagi, T.; Bertolo, R.; Maurer, T.; Ho Rha, K.; Long, J. A.; Yang, B.; Schips, L.; Lima, E.; Breda, A.; Linares, E.; Celia, A.; De Nunzio, C.; Dobbs, R.; Patel, S.; Hamilton, Z.; Tracey, A.; Larcher, A.; Trombetta, C.; Palumbo, C.; Tanabe, K.; Amiel, T.; Raheem, A.; Fiard, G.; Zhang, C.; Castellucci, R.; Palou, J.; Ryan, S.; Crivellaro, S.; Montorsi, F.; Porpiglia, F.; Derweesh, I. H.. - In: EUROPEAN UROLOGY FOCUS. - ISSN 2405-4569. - 6:5(2020), pp. 982-990. [10.1016/j.euf.2019.02.010]
Trifecta outcomes of partial nephrectomy in patients over 75 years old. Analysis of the renal surgery in elderly (RESURGE) group
De Nunzio C.;
2020
Abstract
Partial nephrectomy in elderly patients provides quality outcomes as measured by trifecta. Tumor complexity is a key determinant for trifecta achievement, and trifecta attainment is associated with improved function. Increasing utilization of robotics has benefits in recovery without compromising quality._Partial nephrectomy (PN) in elderly patients is underutilized with concerns regarding risk of complications and potential for poor outcomes. Objective_ To evaluate quality and functional outcomes of PN in patients _75 yr using trifecta as a composite outcome of surgical quality. Design, setting, and participants_ Multicenter retrospective analysis of 653 patients aged _75 yr who underwent PN (REnal SURGery in Elderly [RESURGE] Group). Intervention_ PN. Outcome measurements and statistical analysis_ Primary outcome was achievement of trifecta (negative margin, no major [Clavien ≥3] urological complications, and ≥90% estimated glomerular filtration rate [eGFR] recovery). Secondary outcomes included chronic kidney disease (CKD) stage III and CKD upstaging. Multivariable analysis (MVA) was used to assess variables for achieving trifecta and functional outcomes. Kaplan-Meier survival analysis (KMA) was used to calculate renal functional outcomes. Results and limitations_ We analyzed 653 patients (mean age 78.4 yr, median follow-up 33 mo| File | Dimensione | Formato | |
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