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Objective: To provide insight into the surgical and oncological outcomes of robotic, laparoscopic and open radical nephrectomy with venous thrombectomy (RALRN-VT, LRN-VT, ORN-VT) in patients with renal tumor and venous thrombus.

Materials and Methods: A propensity-matched retrospective cohort study containing 324 patients with renal tumor and venous thrombus from January 2014 to August 2021 was analyzed. We compared surgical outcomes and we used the Kalan-Meier method to assess the overall survival (OS), tumor-specific survival (TSS), metastasis-free survival (MFS) and local recurrence-free survival (LRFS). The Pearson chi-square test and Fisher exact test, Wilcoxon rank sum test, Cox proportional hazards regression model and log-rank test were used.

Results: After matching, baseline characteristics were comparable in the RALRN-VT, LRN-VT and ORN-VT group. The RALRN-VT group had the least operative time (median 134 min vs 289 min vs 330 min, P < 0.001), the least blood loss (median 250 ml vs 500 ml vs 1000 ml, P < 0.001) and the fewest packed red blood cells transfusion (median 400 ml vs 800 ml vs 1200 ml, P < 0.001). The ORN-VT group had the highest complication rate (18.2 vs 22.7 vs 43.2%, P = 0.005), the highest Clavien grade (P = 0.001) and the longest postoperative hospital stay (median 7d vs 8d vs 10d, P < 0.001). No significant difference in OS, TSS and MFS between the minimally invasive procedures (MIP, including RALRN-VT and LRN-VT) group and ORN-VT group was found. The hazard ratio of LRFS for the MIP group was 0.20 (95% CI 0.06-0.70, P = 0.01) compared with ORN-VT group.

Conclusions: RALRN-VT can result in the best surgical outcomes compared with LRN-VT and ORN-VT. The MIP group had a better LRFS compared with ORN-VT group.

Titel:	Comparative analysis of surgical and oncologic outcomes of robotic, laparoscopic and open radical nephrectomy with venous thrombectomy: a propensity-matched cohort study.
Autor/in / Beteiligte Person:	Zhang, Y ; Bi, H ; Yan, Y ; Liu, Z ; Wang, G ; Song, Y ; Zhang, S ; Liu, C ; Ma, L
Link:	View record at Springer (Volltext)
Zeitschrift:	International journal of clinical oncology, Jg. 28 (2023), Heft 1, S. 145-154
Veröffentlichung:	1998- : Tokyo : Springer-Verlag Tokyo ; <i>Original Publication</i>: Tokyo : Published for the Japan Society of Clinical Oncology by Churchill Livingstone, c1996-, 2023
Medientyp:	academicJournal
ISSN:	1437-7772 (electronic)
DOI:	10.1007/s10147-022-02265-y
Schlagwort:	Humans Cohort Studies Retrospective Studies Nephrectomy methods Thrombectomy Treatment Outcome Carcinoma, Renal Cell pathology Robotic Surgical Procedures Kidney Neoplasms pathology Laparoscopy methods
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [Int J Clin Oncol] 2023 Jan; Vol. 28 (1), pp. 145-154. <i>Date of Electronic Publication: </i>2022 Nov 15. MeSH Terms: Carcinoma, Renal Cell* / pathology ; Robotic Surgical Procedures* ; Kidney Neoplasms* / pathology ; Laparoscopy* / methods ; Humans ; Cohort Studies ; Retrospective Studies ; Nephrectomy / methods ; Thrombectomy ; Treatment Outcome References: Disanto V, Pansadoro V, Portoghese F et al (2005) Retroperitoneal laparoscopic radical nephrectomy for renal cell carcinoma with infrahepatic vena caval thrombus. Eur Urol 47(3):352–356. https://doi.org/10.1016/j.eururo.2004.11.010. (PMID: 10.1016/j.eururo.2004.11.010) ; Shao P, Li J, Qin C et al (2015) Laparoscopic radical nephrectomy and inferior vena cava thrombectomy in the treatment of renal cell carcinoma. Eur Urol 68(1):115–122. https://doi.org/10.1016/j.eururo.2014.12.011. 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(PMID: 10.1016/j.ejso.2015.02.009) Grant Information: 81972381 National Nature Science Foundation of China Contributed Indexing: Keywords: Laparoscopic procedure; Open procedure; Propensity-matched; Robotic; Venous thrombectomy Entry Date(s): Date Created: 20221115 Date Completed: 20230110 Latest Revision: 20230111 Update Code: 20240513

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Comparative analysis of surgical and oncologic outcomes of robotic, laparoscopic and open radical nephrectomy with venous thrombectomy: a propensity-matched cohort study.