Korean J Urol Oncol.  2021 Aug;19(3):183-192. 10.22465/kjuo.2021.19.3.183.

Perioperative and Oncological Outcomes of 1,002 Consecutive Patients With Localized Renal Cell Carcinoma Treated by Robotic Partial Nephrectomy at a Single Center

• Kim T
• Chung JH
• Sung HH
• Jeon HG
• Jeong BC
• Jeon SS
• Lee HM
• Kang M
• Seo SI

• KMID: 2519770
• DOI: http://doi.org/10.22465/kjuo.2021.19.3.183

Abstract

Purpose
To analyze and compare the results of robotic partial nephrectomy (RPN) at a single center with the previous large-scale studies in terms of perioperative and oncological outcomes.
Materials and Methods
We retrospectively evaluated 1,013 cases of RPN in our center database from December 2008 to August 2018. Total 11 cases were excluded in final analysis. We evaluated perioperative outcomes as the Trifecta achievement, which is defined as no positive surgical margin (PSM), no perioperative complications greater than Clavien-Dindo classification I and a warm ischemia time of <25 minutes. In addition, we analyzed pathological and oncological outcomes; recurrence, metastasis, all-cause deaths, cancer-specific deaths, and 5-year survival rates.
Results
In 1,002 cases, the Trifecta achievement was 61.1% (n=612). The postoperative complication was 18.4% (n=184) but most were grade 2 or less (14.9%, n=145). Ninety-three cases (9.28%) had benign and 907 cases (90.5%) had malignant pathologies. A local recurrence were 14 cases (1.54%) and distant metastasis were 20 cases (2.2%) during follow-up periods. Allcause death rate was 1.2% (n=11) and cancer-specific death rate was 0.2% (n=2). The median follow-up period was 39 months. A 5-year recurrence-free survival rate, cancer-specific survival rate, and overall survival rate were 95.2%, 99.7%, and 98.4%.
Conclusions
In summary, our data shows comparable perioperative outcomes to other largescale studies of RPN in terms of the Trifecta achievement with similar baseline characteristics. In terms of oncological outcomes, there was lower rate of PSM and similar recurrence free survival rate.

Keyword

Nephron-sparing surgery, Robotic partial nephrectomy, Trifecta