Robotic Nephrectomy for Localized RCC On The Rise
In 2013, nearly one third of all minimally invasive radical nephrectomies were performed with robotic assistance.
Use of robotic radical nephectomy (RRN) to treat stage 1 renal cell carcinoma (RCC) is on the rise in the United States, investigators reported at the Society of Urologic Oncology 17th annual meeting in San Antonio, Texas.
Using the National Cancer Data Base, Matthew Bream, MD, and colleagues at Case Western Reserve University in Cleveland identified 15,756 patients undergoing minimally invasive radical nephrectomy (RN)—either robotic radical nephrectomy (RRN) or laparoscopic RN (LRN)—for localized T1 RCC from 2010 to 2013. During the 4-year study period, 25% of these patients underwent RRN, with the proportion of cases treated with RRN increasing significantly over time from 18% in 2010 to 31% in 2013, Dr Bream's group stated in a poster presentation.
On multivariable analysis, patients treated at academic hospitals had significant 29% higher odds of undergoing RRN compared with those treated at community hospitals, the investigators reported. Patients with tumor size of 4 cm or less and those who underwent retroperitoneal lymph node dissection had significant 25% and 86% higher odds, respectively, of undergoing RRN.
The RRN and LRN groups were similar with respect to perioperative quality indicators and conversion to open surgery.
“With similar perioperative quality outcomes and increased attention to health care costs, RRN may face greater scrutiny as a surgical option for localized RCC,” Dr Bream and his colleagues concluded.
1. Bream M, Francis J, Abouassaly R, Kim S. National utilization of robotic radical nephrectomy for clinical stage 1 renal cell carcinoma: Results from a population-based cohort. Poster presented at the Society of Urologic Oncology 17th annual meeting, San Antonio, Texas. Poster 44.