Outcomes and predictors of clinical T1 to pathological T3a tumor up-staging after robotic partial nephrectomy: A multi-institutional analysis

Michael Gorin, Mark W. Ball, Phillip Martin Pierorazio, Youssef S. Tanagho, Sam B. Bhayani, Jihad H. Kaouk, Craig G. Rogers, Michael D. Stifelman, Ali Khalifeh, Ramesh Kumar, Ganesh Sivarajan, Mohamad E Allaf

Research output: Contribution to journalArticle

Abstract

Purpose: We evaluated the early oncological end point of recurrence-free survival in patients with renal cell carcinoma up-staged from cT1 to pT3a after partial nephrectomy. We also aimed to establish preoperative factors associated with pathological tumor up-staging. Materials and Methods: A prospective database of robotic partial nephrectomy cases performed at 5 academic centers was queried for patients who underwent surgery for a solitary cT1 renal mass. Patients with pT1-2 renal cell carcinoma were compared to those with pT3a tumors to determine the difference in recurrence-free survival. Preoperative factors associated with cT1 to pT3a up-staging were studied using multivariate logistic regression analysis. Results: A total of 1,096 patients underwent robotic partial nephrectomy for a cT1 renal mass. At final pathological evaluation 855 tumors (78.0%) were found to be renal cell carcinoma, of which 41 (4.8%) were up-staged to pT3a. The 24-month recurrence-free survival estimates for pT1-2 and pT3a tumors were 99.2% and 91.8%, respectively (p = 0.003). Multivariate analysis revealed that a high vs low R.E.N.A.L. (radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior and location relative to polar lines) nephrometry score was associated with tumor up-staging (OR 2.97, 95% CI 1.20-7.35, p = 0.02). On separate multivariate analysis increasing tumor diameter (OR 1.66, 95% CI 1.32-2.08, p

Original languageEnglish (US)
Pages (from-to)1907-1911
Number of pages5
JournalJournal of Urology
Volume190
Issue number5
DOIs
StatePublished - Nov 2013

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Neoplasm Staging
Robotics
Nephrectomy
Renal Cell Carcinoma
Recurrence
Survival
Neoplasms
Multivariate Analysis
Kidney
Logistic Models
Regression Analysis
Databases

Keywords

  • Carcinoma, renal cell
  • Kidney
  • Neoplasm staging
  • Nephrectomy
  • Robotics

ASJC Scopus subject areas

  • Urology

Cite this

Outcomes and predictors of clinical T1 to pathological T3a tumor up-staging after robotic partial nephrectomy : A multi-institutional analysis. / Gorin, Michael; Ball, Mark W.; Pierorazio, Phillip Martin; Tanagho, Youssef S.; Bhayani, Sam B.; Kaouk, Jihad H.; Rogers, Craig G.; Stifelman, Michael D.; Khalifeh, Ali; Kumar, Ramesh; Sivarajan, Ganesh; Allaf, Mohamad E.

In: Journal of Urology, Vol. 190, No. 5, 11.2013, p. 1907-1911.

Research output: Contribution to journalArticle

Gorin, Michael ; Ball, Mark W. ; Pierorazio, Phillip Martin ; Tanagho, Youssef S. ; Bhayani, Sam B. ; Kaouk, Jihad H. ; Rogers, Craig G. ; Stifelman, Michael D. ; Khalifeh, Ali ; Kumar, Ramesh ; Sivarajan, Ganesh ; Allaf, Mohamad E. / Outcomes and predictors of clinical T1 to pathological T3a tumor up-staging after robotic partial nephrectomy : A multi-institutional analysis. In: Journal of Urology. 2013 ; Vol. 190, No. 5. pp. 1907-1911.
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abstract = "Purpose: We evaluated the early oncological end point of recurrence-free survival in patients with renal cell carcinoma up-staged from cT1 to pT3a after partial nephrectomy. We also aimed to establish preoperative factors associated with pathological tumor up-staging. Materials and Methods: A prospective database of robotic partial nephrectomy cases performed at 5 academic centers was queried for patients who underwent surgery for a solitary cT1 renal mass. Patients with pT1-2 renal cell carcinoma were compared to those with pT3a tumors to determine the difference in recurrence-free survival. Preoperative factors associated with cT1 to pT3a up-staging were studied using multivariate logistic regression analysis. Results: A total of 1,096 patients underwent robotic partial nephrectomy for a cT1 renal mass. At final pathological evaluation 855 tumors (78.0{\%}) were found to be renal cell carcinoma, of which 41 (4.8{\%}) were up-staged to pT3a. The 24-month recurrence-free survival estimates for pT1-2 and pT3a tumors were 99.2{\%} and 91.8{\%}, respectively (p = 0.003). Multivariate analysis revealed that a high vs low R.E.N.A.L. (radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior and location relative to polar lines) nephrometry score was associated with tumor up-staging (OR 2.97, 95{\%} CI 1.20-7.35, p = 0.02). On separate multivariate analysis increasing tumor diameter (OR 1.66, 95{\%} CI 1.32-2.08, p",
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T1 - Outcomes and predictors of clinical T1 to pathological T3a tumor up-staging after robotic partial nephrectomy

T2 - A multi-institutional analysis

AU - Gorin, Michael

AU - Ball, Mark W.

AU - Pierorazio, Phillip Martin

AU - Tanagho, Youssef S.

AU - Bhayani, Sam B.

AU - Kaouk, Jihad H.

AU - Rogers, Craig G.

AU - Stifelman, Michael D.

AU - Khalifeh, Ali

AU - Kumar, Ramesh

AU - Sivarajan, Ganesh

AU - Allaf, Mohamad E

PY - 2013/11

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N2 - Purpose: We evaluated the early oncological end point of recurrence-free survival in patients with renal cell carcinoma up-staged from cT1 to pT3a after partial nephrectomy. We also aimed to establish preoperative factors associated with pathological tumor up-staging. Materials and Methods: A prospective database of robotic partial nephrectomy cases performed at 5 academic centers was queried for patients who underwent surgery for a solitary cT1 renal mass. Patients with pT1-2 renal cell carcinoma were compared to those with pT3a tumors to determine the difference in recurrence-free survival. Preoperative factors associated with cT1 to pT3a up-staging were studied using multivariate logistic regression analysis. Results: A total of 1,096 patients underwent robotic partial nephrectomy for a cT1 renal mass. At final pathological evaluation 855 tumors (78.0%) were found to be renal cell carcinoma, of which 41 (4.8%) were up-staged to pT3a. The 24-month recurrence-free survival estimates for pT1-2 and pT3a tumors were 99.2% and 91.8%, respectively (p = 0.003). Multivariate analysis revealed that a high vs low R.E.N.A.L. (radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior and location relative to polar lines) nephrometry score was associated with tumor up-staging (OR 2.97, 95% CI 1.20-7.35, p = 0.02). On separate multivariate analysis increasing tumor diameter (OR 1.66, 95% CI 1.32-2.08, p

AB - Purpose: We evaluated the early oncological end point of recurrence-free survival in patients with renal cell carcinoma up-staged from cT1 to pT3a after partial nephrectomy. We also aimed to establish preoperative factors associated with pathological tumor up-staging. Materials and Methods: A prospective database of robotic partial nephrectomy cases performed at 5 academic centers was queried for patients who underwent surgery for a solitary cT1 renal mass. Patients with pT1-2 renal cell carcinoma were compared to those with pT3a tumors to determine the difference in recurrence-free survival. Preoperative factors associated with cT1 to pT3a up-staging were studied using multivariate logistic regression analysis. Results: A total of 1,096 patients underwent robotic partial nephrectomy for a cT1 renal mass. At final pathological evaluation 855 tumors (78.0%) were found to be renal cell carcinoma, of which 41 (4.8%) were up-staged to pT3a. The 24-month recurrence-free survival estimates for pT1-2 and pT3a tumors were 99.2% and 91.8%, respectively (p = 0.003). Multivariate analysis revealed that a high vs low R.E.N.A.L. (radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior and location relative to polar lines) nephrometry score was associated with tumor up-staging (OR 2.97, 95% CI 1.20-7.35, p = 0.02). On separate multivariate analysis increasing tumor diameter (OR 1.66, 95% CI 1.32-2.08, p

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KW - Kidney

KW - Neoplasm staging

KW - Nephrectomy

KW - Robotics

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