Open Partial Nephrectomy Vs. Robot-Assisted Partial Nephrectomy for Cystic Renal Masses: Impact of Peroperative Cystic Spillage and Oncological Results.

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy III1 Apr 2017MP55-09 OPEN PARTIAL NEPHRECTOMY VS. ROBOT-ASSISTED PARTIAL NEPHRECTOMY FOR CYSTIC RENAL MASSES: IMPACT OF PEROPERATIVE CYSTIC SPILLAGE AND ONCOLOGICAL RESULTS. Benjamin PRADERE, Benoit PEYRONNET, Quentin Manach, Zineddine Khene, Gauthier Delporte, Jérome Rizk, Jean Baptiste Beauval, Thomas Seisen, Morgan Moulin, Nicolas Brichart, Axel Bex, Morgan Roupret, Franck Bruyère, and Karim BENSALAH Benjamin PRADEREBenjamin PRADERE More articles by this author , Benoit PEYRONNETBenoit PEYRONNET More articles by this author , Quentin ManachQuentin Manach More articles by this author , Zineddine KheneZineddine Khene More articles by this author , Gauthier DelporteGauthier Delporte More articles by this author , Jérome RizkJérome Rizk More articles by this author , Jean Baptiste BeauvalJean Baptiste Beauval More articles by this author , Thomas SeisenThomas Seisen More articles by this author , Morgan MoulinMorgan Moulin More articles by this author , Nicolas BrichartNicolas Brichart More articles by this author , Axel BexAxel Bex More articles by this author , Morgan RoupretMorgan Roupret More articles by this author , Franck BruyèreFranck Bruyère More articles by this author , and Karim BENSALAHKarim BENSALAH More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1702AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES It is recommended to remove suspect cystic renal tumours when they are classified as Bosniak ≥3. These masses are fragile and may rupture during dissection or tumour excision. The impact of this intraoperative spillage on oncological outcomes remains uncertain. The objective of this study was to assess incidence of intraoperative cystic rupture according to surgical approach and its impact on oncological outcomes. METHODS Between 2005 and 2015, patients who had a partial nephrectomy (PN) in height European centres have been retrospectively analysed. We specifically sought if there was a cystic spillage during the procedure. Oncological outcomes included overall survival (OS), disease specific survival (DSS) and recurrence-free survival (RFS). We performed a sub-group analysis on surgical approach (open partial nephrectomy (OPN) vs. robot-assisted partial nephrectomy (RAPN)) and on the existence of intraoperative cystic spillage (ICS) to determine their impact on oncological outcomes. Kaplan-Meier curves of RFS were produced. A multivariate analysis with logistic regression model was used to assess predictors of intraoperative cystic spillage. RESULTS Overall, 268 patients were included. Malignancy of cystic renal masses was found in 75% of cases. Among them, 84.5% were Bosniak IV, 68% were Bosniak III and 62.5% were Bosniak IIF on preoperative CT-scan. With a mean follow-up of 32 months, OS was 95.1%, only 2% had a local recurrence, metastatic progression was found in 2% of cases and there was no specific-disease death. We reported intraoperative cystic spillage (ICS) in 18.7% (n=50) of cases (20% during RAPN vs. 18% during OPN). Among them, 77.5% were confirmed to be malignant after pathological analysis. In the ICS subgroup, with a median follow-up of 38 months, no local recurrence or metastatic progression was reported. Analyses of RFS did not found any difference among subgroups: ICS vs. no ICS (P=0.23) (Figure 1), OPN vs. RAPN (P=0.91) (Figure 2). No predictive factor of ICS was found. CONCLUSIONS Intraoperative cystic spillage is rather common regardless the surgical approach, and it does not seem to impact mid-term oncological outcomes. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e733-e734 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Benjamin PRADERE More articles by this author Benoit PEYRONNET More articles by this author Quentin Manach More articles by this author Zineddine Khene More articles by this author Gauthier Delporte More articles by this author Jérome Rizk More articles by this author Jean Baptiste Beauval More articles by this author Thomas Seisen More articles by this author Morgan Moulin More articles by this author Nicolas Brichart More articles by this author Axel Bex More articles by this author Morgan Roupret More articles by this author Franck Bruyère More articles by this author Karim BENSALAH More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...