A comparison of open, laparoscopic, and robotic radical nephrectomy with tumor thrombectomy from the intercontinental collaboration on renal cell carcinoma
Cannoletta, Donato (Instituto Alexander Fleming)
Spiess, Philippe E. (H. Lee Moffitt Cancer Center & Research Institute)
Abreu, Diego (Hospital Pasteur)
Rodríguez, Alejandro (Atrium Health Wake Forest Baptist Medical Center)
Sandberg, Maxwell (Atrium Health Wake Forest Baptist Medical Center)
Russell, Gregory (Wake Forest University School of Medicine)
Malakismail, Jacob (Rosalind Franklin University of Medicine and Science)
Hayes, Mitchell (H. Lee Moffitt Cancer Center & Research Institute)
David, Reuben Ben (Icahn School of Medicine at Mount Sinai (Nova York, Estats Units d'Amèrica))
Miller, Justin (University of South Florida Health Morsani College of Medicine)
Patel, Kartik (University of Alabama Birmingham Medical Center)
Aljabi, Brejjette (University of Alabama Birmingham Medical Center)
Byun, Seok Soon (Seoul National University Bundang Medical Center)
Rodríguez Faba, Óscar (Institut de Recerca Sant Pau)
Letowski, Tatiana (Instituto Alexander Fleming)
Villoldo, Gustavo (Instituto Alexander Fleming)
Marchinena, Patricio Garcia (Hospital Italiano)
Mourao, Thiago (A.C. Camargo Cancer Institute)
Ciancio, Gaetano (University of Miami Miller School of Medicine)
Peyton, Charles C. (University of Alabama Birmingham Medical Center)
Zanotti, Rafael (A.C. Camargo Cancer Institute)
Mehrazin, Reza (Icahn School of Medicine at Mount Sinai (Nova York, Estats Units d'Amèrica))
Zequi, Stênio de Cássio (A.C. Camargo Cancer Institute)
Universitat Autònoma de Barcelona. Departament de Medicina

Fecha:	2025
Resumen:	The gold standard treatment for renal cell carcinoma with a tumor thrombus (RCC-TT) is radical nephrectomy with tumor thrombectomy (RN-TT). Operative approaches to this can be done open (ORN-TT), laparoscopic (LRN-TT), or robotic (RRN-TT). The purpose of this study was to compare overall survival (OS), cancer-specific survival (CSS), and metastasis-free survival (MFS) between open, laparoscopic, and robotic approaches to RN-TT using the Intercontinental Collaboration on Renal Cell Carcinoma (ICORCC) database. Patient records were reviewed from the ICORCC database. All patients included in the study underwent RN-TT for RCC-TT from 1999 to present. Tumor thrombus level was graded using the Neves classification system. Statistical analysis was carried out using analysis of variance, chi-squared test, and Kaplan-Meier survival curves with log-rank test to compare outcomes by surgical approach. A total of 392 patients were included. There were 308 ORN-TT, 61 LRN-TT, and 23 RRN-TT cases. On Kaplan-Meier analysis, OS and CSS were not significantly different by approach (p > 0. 05). MFS was significantly lower in RRN-TT patients (p = 0. 030). Operative time was the longest in ORN-TT, followed by LRN-TT, and RRN-TT the quickest (p = 0. 011). Blood transfusion rates were significantly lower in RRN-TT relative to ORN-TT (p < 0. 001). Rates of lymph node dissection, soft tissue margin positivity, and cytoreductive surgery were alike (p > 0. 05). There is no definitive superiority of one operative approach compared to another. RRN-TT may result in worse MFS for patients, which calls for further investigation, but this is not certain. Ultimately, the risks, benefits, and resources the surgeon has at his/her disposal should all play in the final operative choice of RN-TT for the patient.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Laparoscopic ; Renal cell carcinoma ; Robotic ; Thrombus ; Urology
Publicado en:	Journal of robotic surgery, Vol. 19, Num. 1 (December 2025) , p. 269, ISSN 1863-2491

Correction: https://intern-ddd.uab.cat/admin/publications/325963
DOI: 10.1007/s11701-025-02424-z
PMID: 40467927

9 p, 800.0 KB

El registro aparece en las colecciones:
Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut de Recerca Sant Pau
Artículos > Artículos de investigación
Artículos > Artículos publicados