Data Support Robot-Assisted Partial Nephrectomy for Kidney Cancer
Robot-assisted partial nephrectomy (RPN) is associated with intermediate-term oncologic and renal function outcomes equivalent to those of laparoscopic and open partial nephrectomy, according to a new study.
Jihad H. Kaouk, MD, and colleagues at Cleveland Clinic's Glickman Urological and Kidney Institute reviewed outcomes of 134 patients who underwent RPN and who had a minimum of two years of follow-up. Of these, 70 had at least three to six years of follow-up. The cohort had a mean age of 59 years and a mean body mass index of 29.8 kg/m2. The mean tumor size based on computed tomography scans was 3 cm.
The overall survival rate was 97.1% at three years and 90.7% at five years, the investigators reported online ahead of print in European Urology. Both the cancer-specific and cancer-free survival rates were 99% at three and five years.
The mean estimated glomerular filtration rate (eGFR) declined from 88.2 mL/min/1.73 m2 preoperatively to 80 mL/min/1.73 m2 at the latest measurement postoperatively. The study showed an upstaging of chronic kidney disease in 20% of patients, but no patients started dialysis.
The mean estimated blood loss was 270.7 mL, the mean operative time 189 minutes, and the mean warm ischemia time was 17.9 minutes.
Two intraoperative complications (1.5%) and five high-grade Clavien complications (3.7%) occurred.