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Comparing Oncological and Perioperative Outcomes of Open versus Laparoscopic versus Robotic Radical Nephroureterectomy for the Treatment of Upper Tract Urothelial Carcinoma: A Multicenter, Multinational, Propensity Score-Matched Analysis
NC. Grossmann, F. Soria, T. Juvet, AM. Potretzke, H. Djaladat, A. Ghoreifi, E. Kikuchi, A. Mari, ZE. Khene, K. Fujita, JD. Raman, A. Breda, M. Fontana, JP. Sfakianos, JL. Pfail, E. Laukhtina, P. Rajwa, M. Pallauf, C. Poyet, GE. Cacciamani, T. van...
Status neindexováno Jazyk angličtina Země Švýcarsko
Typ dokumentu časopisecké články
NLK
Directory of Open Access Journals
od 2010
Free Medical Journals
od 2009
PubMed Central
od 2009
Europe PubMed Central
od 2009
ProQuest Central
od 2009-01-01
Open Access Digital Library
od 2009-01-01
Open Access Digital Library
od 2009-01-01
ROAD: Directory of Open Access Scholarly Resources
od 2009
PubMed
36900201
DOI
10.3390/cancers15051409
Knihovny.cz E-zdroje
- Publikační typ
- časopisecké články MeSH
OBJECTIVES: To identify correlates of survival and perioperative outcomes of upper tract urothelial carcinoma (UTUC) patients undergoing open (ORNU), laparoscopic (LRNU), and robotic (RRNU) radical nephroureterectomy (RNU). METHODS: We conducted a retrospective, multicenter study that included non-metastatic UTUC patients who underwent RNU between 1990-2020. Multiple imputation by chained equations was used to impute missing data. Patients were divided into three groups based on their surgical treatment and were adjusted by 1:1:1 propensity score matching (PSM). Survival outcomes per group were estimated for recurrence-free survival (RFS), bladder recurrence-free survival (BRFS), cancer-specific survival (CSS), and overall survival (OS). Perioperative outcomes: Intraoperative blood loss, hospital length of stay (LOS), and overall (OPC) and major postoperative complications (MPCs; defined as Clavien-Dindo > 3) were assessed between groups. RESULTS: Of the 2434 patients included, 756 remained after PSM with 252 in each group. The three groups had similar baseline clinicopathological characteristics. The median follow-up was 32 months. Kaplan-Meier and log-rank tests demonstrated similar RFS, CSS, and OS between groups. BRFS was found to be superior with ORNU. Using multivariable regression analyses, LRNU and RRNU were independently associated with worse BRFS (HR 1.66, 95% CI 1.22-2.28, p = 0.001 and HR 1.73, 95%CI 1.22-2.47, p = 0.002, respectively). LRNU and RRNU were associated with a significantly shorter LOS (beta -1.1, 95% CI -2.2-0.02, p = 0.047 and beta -6.1, 95% CI -7.2-5.0, p < 0.001, respectively) and fewer MPCs (OR 0.5, 95% CI 0.31-0.79, p = 0.003 and OR 0.27, 95% CI 0.16-0.46, p < 0.001, respectively). CONCLUSIONS: In this large international cohort, we demonstrated similar RFS, CSS, and OS among ORNU, LRNU, and RRNU. However, LRNU and RRNU were associated with significantly worse BRFS, but a shorter LOS and fewer MPCs.
Department of Urology 2nd Faculty of Medicine Charles University 150 06 Prague Czech Republic
Department of Urology Comprehensive Cancer Center Medical University of Vienna 1090 Vienna Austria
Department of Urology Icahn School of Medicine at Mount Sinai New York NY 10029 USA
Department of Urology Kindai University Faculty of Medicine Osaka 589 8511 Japan
Department of Urology Lions Gate Hospital North Vancouver BC V7L 2L7 Canada
Department of Urology Luzerner Kantonsspital 6004 Lucerne Switzerland
Department of Urology Mayo Clinic Rochester MN 55902 USA
Department of Urology Medical University of Silesia 40 752 Katowice Poland
Department of Urology Penn State Health Hershey PA 17033 USA
Department of Urology St Marianna University School of Medicine Kawasaki 214 8525 Japan
Department of Urology University Hospital Zurich 8091 Zurich Switzerland
Department of Urology University Medical Center Hamburg Eppendorf 20251 Hamburg Germany
Department of Urology University of Florence Careggi Hospital 50100 Florence Italy
Department of Urology University of Rennes 35000 Rennes France
Department of Urology University of Texas Southwestern Dallas TX 75390 USA
Department of Urology UROSUD La Croix Du Sud Hospital 31130 Quint Fonsegrives France
Department of Urology Weill Cornell Medical College New York NY 10065 USA
Hourani Center for Applied Scientific Research Al Ahliyya Amman University Amman 19328 Jordan
Institute for Urology and Reproductive Health Sechenov University 119991 Moscow Russia
Karl Landsteiner Institute of Urology and Andrology 1090 Vienna Austria
Urology Department Fundació Puigvert Autonomous University of Barcelona 08025 Barcelona Spain
Vattikuti Urology Institute Henry Ford Hospital Detroit MI 48202 USA
Citace poskytuje Crossref.org
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- $a Grossmann, Nico C $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria $u Department of Urology, University Hospital Zurich, 8091 Zurich, Switzerland $u Department of Urology, Luzerner Kantonsspital, 6004 Lucerne, Switzerland $1 https://orcid.org/0000000186986461
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- $a OBJECTIVES: To identify correlates of survival and perioperative outcomes of upper tract urothelial carcinoma (UTUC) patients undergoing open (ORNU), laparoscopic (LRNU), and robotic (RRNU) radical nephroureterectomy (RNU). METHODS: We conducted a retrospective, multicenter study that included non-metastatic UTUC patients who underwent RNU between 1990-2020. Multiple imputation by chained equations was used to impute missing data. Patients were divided into three groups based on their surgical treatment and were adjusted by 1:1:1 propensity score matching (PSM). Survival outcomes per group were estimated for recurrence-free survival (RFS), bladder recurrence-free survival (BRFS), cancer-specific survival (CSS), and overall survival (OS). Perioperative outcomes: Intraoperative blood loss, hospital length of stay (LOS), and overall (OPC) and major postoperative complications (MPCs; defined as Clavien-Dindo > 3) were assessed between groups. RESULTS: Of the 2434 patients included, 756 remained after PSM with 252 in each group. The three groups had similar baseline clinicopathological characteristics. The median follow-up was 32 months. Kaplan-Meier and log-rank tests demonstrated similar RFS, CSS, and OS between groups. BRFS was found to be superior with ORNU. Using multivariable regression analyses, LRNU and RRNU were independently associated with worse BRFS (HR 1.66, 95% CI 1.22-2.28, p = 0.001 and HR 1.73, 95%CI 1.22-2.47, p = 0.002, respectively). LRNU and RRNU were associated with a significantly shorter LOS (beta -1.1, 95% CI -2.2-0.02, p = 0.047 and beta -6.1, 95% CI -7.2-5.0, p < 0.001, respectively) and fewer MPCs (OR 0.5, 95% CI 0.31-0.79, p = 0.003 and OR 0.27, 95% CI 0.16-0.46, p < 0.001, respectively). CONCLUSIONS: In this large international cohort, we demonstrated similar RFS, CSS, and OS among ORNU, LRNU, and RRNU. However, LRNU and RRNU were associated with significantly worse BRFS, but a shorter LOS and fewer MPCs.
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