BacKgroUnD: We proposed a new tool (named ROMe’s) to summarize long-term outcomes after partial nephrectomy (PN), identified its predictors and generated a predicting nomogram. MeTHoDS: a retrospective analysis of a multicenter dataset of patients with non-metastatic pT1-3a renal cell carcinoma was performed. Baseline demographic, clinical, pathologic and perioperative data were collected. ROMe’s was defined as the concomitant lack of cancer-recurrences, death and newly onset Chronic Kidney Disease (CKD), at long term follow-up. Kaplan-Meier method investigated the predictive role of Trifecta on ROMe’s achievement. Univariable and multivariable Cox regression analyses identified its predictors. A nomogram was generated and its accuracy was quantified using concordance index (CI). A calibration plot was obtained with 200 bootstraps resampling to explore nomogram performance at 5 years and decision curve analyses (DCA) assessed the net benefit of the model at 12, 36 and 60 months. reSUlTS: We included 927 patients. The rates of ROMe’s were 82%, 72% and 56% at 1, 3 and 5 years follow-up. at Kaplan-Meier analysis, patients who achieved Trifecta displayed a significantly higher probability of ROMe’s (log rank P<0.001). Young age (OR=0.982; P=0.001), low RENAL score (OR=0.86; P=0.037), high preoperative filtration rate (or=1.02; P<0.001) and Trifecta achievement (or=2.03; P=0.015), were independent predictors of ROMe’s. The nomogram showed a CI of 0.76 at 60 months. The 5-years calibration plot confirmed a good discrimination accuracy (0.74); on DCA, the net benefit of using the model was evident for probabilities >30%. conclUSionS: We conceived a triad to summarize the main long-term oncologic and functional outcomes after Pn and generated a predicting nomogram.

Comprehensive long-term assessment of outcomes following robot-assisted partial nephrectomy for renal cell carcinoma. The ROMe’s achievement and its predicting nomogram / Brassetti, A.; Anceschi, U.; Bertolo, R.; Ferriero, M.; Tuderti, G.; Costantini, M.; Capitanio, U.; Larcher, A.; Antonelli, A.; Mottrie, A.; Minervini, A.; Dell'Oglio, P.; Veccia, A.; Amparore, D.; Flammia, R. S.; Lombardo, R.; de Nunzio, C.; Benecchi, L.; Mari, A.; Porpiglia, F.; Montorsi, F.; Kaouk, J.; Autorino, R.; Gallucci, M.; Simone, G.. - In: MINERVA UROLOGICA E NEFROLOGICA. - ISSN 0393-2249. - 72:4(2020), pp. 482-489. [10.23736/S0393-2249.20.03813-8]

Comprehensive long-term assessment of outcomes following robot-assisted partial nephrectomy for renal cell carcinoma. The ROMe’s achievement and its predicting nomogram

Brassetti A.;Anceschi U.;Ferriero M.;Tuderti G.;Minervini A.;Veccia A.;Flammia R. S.;Lombardo R.;de Nunzio C.;Gallucci M.;
2020

Abstract

BacKgroUnD: We proposed a new tool (named ROMe’s) to summarize long-term outcomes after partial nephrectomy (PN), identified its predictors and generated a predicting nomogram. MeTHoDS: a retrospective analysis of a multicenter dataset of patients with non-metastatic pT1-3a renal cell carcinoma was performed. Baseline demographic, clinical, pathologic and perioperative data were collected. ROMe’s was defined as the concomitant lack of cancer-recurrences, death and newly onset Chronic Kidney Disease (CKD), at long term follow-up. Kaplan-Meier method investigated the predictive role of Trifecta on ROMe’s achievement. Univariable and multivariable Cox regression analyses identified its predictors. A nomogram was generated and its accuracy was quantified using concordance index (CI). A calibration plot was obtained with 200 bootstraps resampling to explore nomogram performance at 5 years and decision curve analyses (DCA) assessed the net benefit of the model at 12, 36 and 60 months. reSUlTS: We included 927 patients. The rates of ROMe’s were 82%, 72% and 56% at 1, 3 and 5 years follow-up. at Kaplan-Meier analysis, patients who achieved Trifecta displayed a significantly higher probability of ROMe’s (log rank P<0.001). Young age (OR=0.982; P=0.001), low RENAL score (OR=0.86; P=0.037), high preoperative filtration rate (or=1.02; P<0.001) and Trifecta achievement (or=2.03; P=0.015), were independent predictors of ROMe’s. The nomogram showed a CI of 0.76 at 60 months. The 5-years calibration plot confirmed a good discrimination accuracy (0.74); on DCA, the net benefit of using the model was evident for probabilities >30%. conclUSionS: We conceived a triad to summarize the main long-term oncologic and functional outcomes after Pn and generated a predicting nomogram.
2020
kidney function tests; kidney neoplasms; nephrectomy; survival
01 Pubblicazione su rivista::01g Articolo di rassegna (Review)
Comprehensive long-term assessment of outcomes following robot-assisted partial nephrectomy for renal cell carcinoma. The ROMe’s achievement and its predicting nomogram / Brassetti, A.; Anceschi, U.; Bertolo, R.; Ferriero, M.; Tuderti, G.; Costantini, M.; Capitanio, U.; Larcher, A.; Antonelli, A.; Mottrie, A.; Minervini, A.; Dell'Oglio, P.; Veccia, A.; Amparore, D.; Flammia, R. S.; Lombardo, R.; de Nunzio, C.; Benecchi, L.; Mari, A.; Porpiglia, F.; Montorsi, F.; Kaouk, J.; Autorino, R.; Gallucci, M.; Simone, G.. - In: MINERVA UROLOGICA E NEFROLOGICA. - ISSN 0393-2249. - 72:4(2020), pp. 482-489. [10.23736/S0393-2249.20.03813-8]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1457520
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