MP59-16 ROBOTIC VERSUS LAPAROSCOPIC RADICAL NEPHRECTOMY: A MATCHED PAIRED MULTICENTER ANALYSIS (ROSULA GROUP)

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy VI1 Apr 2018MP59-16 ROBOTIC VERSUS LAPAROSCOPIC RADICAL NEPHRECTOMY: A MATCHED PAIRED MULTICENTER ANALYSIS (ROSULA GROUP) Uzoma Anele, Riccardo Autorino, Ithaar Derweesh, Bo Yang, Chao Zang, Giuseppe Simone, Michelle Gallucci, Gabriele Tuderti, Manuela Constantini, Robert Uzzo, Alexander Kutikov, David Chen, Marc Smaldone, Stephen Ryan, Ahmet Bindayi, James Porter, Michael Liao, Umberto Capitanio, Alessandro Larcher, Francesco Montorsi, Clayton Lau, Patrick Kilday, Ken Jacobsohn, Peter Langenstroer, Peter Dietrich, Ross Everett, Prokar Dasgupta, Nicolo de Luyk, Ben Challacombe, Andrea Minervini, Andrea Mari, Marco Carini, Koon Rha, Kidon Chang, Riccardo Bertolo, Alexandre Mottrie, Geert De Naeyer, Monish Aron, Chandru Sundaram, Jay Sulek, Wesley White, Luigi Schips, Francesco Beradinelli, Sisto Perdona, Giuseppe Quarto, Daniel Eun, Matteo Ferro, Francesco Porpiglia, and Lance Hampton Uzoma AneleUzoma Anele More articles by this author , Riccardo AutorinoRiccardo Autorino More articles by this author , Ithaar DerweeshIthaar Derweesh More articles by this author , Bo YangBo Yang More articles by this author , Chao ZangChao Zang More articles by this author , Giuseppe SimoneGiuseppe Simone More articles by this author , Michelle GallucciMichelle Gallucci More articles by this author , Gabriele TudertiGabriele Tuderti More articles by this author , Manuela ConstantiniManuela Constantini More articles by this author , Robert UzzoRobert Uzzo More articles by this author , Alexander KutikovAlexander Kutikov More articles by this author , David ChenDavid Chen More articles by this author , Marc SmaldoneMarc Smaldone More articles by this author , Stephen RyanStephen Ryan More articles by this author , Ahmet BindayiAhmet Bindayi More articles by this author , James PorterJames Porter More articles by this author , Michael LiaoMichael Liao More articles by this author , Umberto CapitanioUmberto Capitanio More articles by this author , Alessandro LarcherAlessandro Larcher More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , Clayton LauClayton Lau More articles by this author , Patrick KildayPatrick Kilday More articles by this author , Ken JacobsohnKen Jacobsohn More articles by this author , Peter LangenstroerPeter Langenstroer More articles by this author , Peter DietrichPeter Dietrich More articles by this author , Ross EverettRoss Everett More articles by this author , Prokar DasguptaProkar Dasgupta More articles by this author , Nicolo de LuykNicolo de Luyk More articles by this author , Ben ChallacombeBen Challacombe More articles by this author , Andrea MinerviniAndrea Minervini More articles by this author , Andrea MariAndrea Mari More articles by this author , Marco CariniMarco Carini More articles by this author , Koon RhaKoon Rha More articles by this author , Kidon ChangKidon Chang More articles by this author , Riccardo BertoloRiccardo Bertolo More articles by this author , Alexandre MottrieAlexandre Mottrie More articles by this author , Geert De NaeyerGeert De Naeyer More articles by this author , Monish AronMonish Aron More articles by this author , Chandru SundaramChandru Sundaram More articles by this author , Jay SulekJay Sulek More articles by this author , Wesley WhiteWesley White More articles by this author , Luigi SchipsLuigi Schips More articles by this author , Francesco BeradinelliFrancesco Beradinelli More articles by this author , Sisto PerdonaSisto Perdona More articles by this author , Giuseppe QuartoGiuseppe Quarto More articles by this author , Daniel EunDaniel Eun More articles by this author , Matteo FerroMatteo Ferro More articles by this author , Francesco PorpigliaFrancesco Porpiglia More articles by this author , and Lance HamptonLance Hampton More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1868AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Robotic-assisted radical nephrectomy (RRN) can be an alternative option to the more established laparoscopic radical nephrectomy (LRN) for the management of large renal masses. However, comparative studies between these two techniques are limited. METHODS A retrospective analysis of the ROSULA database comprised of 20 international institutions for RRN & LRN of ≥cT2 renal masses was performed. Peri-operative, functional, and oncologic outcomes were compared between each approach. Descriptive analyses were performed for patient demographics, lesion characteristics, and peri-operative variables. Multivariable analysis (MVA) was used to identify predictors of a composite "trifecta" outcome arbitrarily defined as a combination of negative margins, absent intra-op complication, and estimated blood loss <100. RESULTS A total of 748 patients (324 RRN, 424 LRN) were identified. There was no difference in terms of gender, age, ASA score, clinical tumor size and RENAL score. Patients undergoing RRN had higher BMI (28.5+5.7 vs 27.5+4.8, p = 0.015) and lower pre-op eGFR (72.4+22.6 vs 79.1+19.4, p < 0.001). Operative time was longer for RRN (194.6+61.7 vs 131.4+68.8 min, p = <0.001). There was no difference in intra-op complication or operative conversion (2.5 vs 4.0%, p = 0.25; 2.8 vs 1.4%, p = 0.19), as well no difference in Clavien grade ≥3 (23 vs. 16%, p = 0.54). Length of stay was shorter for RRN (3.4+2.5vs 5.8+3.0 days, p<0.001). At discharge, hemoglobin was lower in RRN (11.6 vs 12.1, p = 0.002), but ?eGFR was similar(30.6+33.3 vs. 29.7+22.9, p =0.67). Higher pathologic staging ≥T3, higher rate of positive margins, and renal vein thrombus was found in RRN (50.2 vs 24.4%, p < 0.001; 6.3 vs 2.7%, p = 0.020; 18.0 vs 5.6%, p < 0.001). MVA revealed RRN to be a significant predictor for "trifecta" outcome (negative margins, absent intra-op complication, and blood loss <100) (OR 2.3, p = 0.009) among pT2 masses. There was no difference in rate of lymphadenectomy (50.6 vs 55%, p = 0.24); however, nodal disease was found more frequently in RRN (13.1 vs 3.6%, p=0.001). There was a higher rate of disease recurrence or metastasis in RRN (25.4 vs 13.4%, p < 0.001); however, there was no difference in overall survival (94.0 vs 91.3%, p = 0.21) at median follow-up 20 mo. Main limitation of the study is the retrospective design. CONCLUSIONS This study represents the largest known multicenter comparison between RRN & LRN approaches for ≥cT2 masses. RRN & LRN demonstrate similar clinical outcomes. The use of RRN might improve likelihood of negative margins, decreased intra-op complications, and blood loss. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e787 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Uzoma Anele More articles by this author Riccardo Autorino More articles by this author Ithaar Derweesh More articles by this author Bo Yang More articles by this author Chao Zang More articles by this author Giuseppe Simone More articles by this author Michelle Gallucci More articles by this author Gabriele Tuderti More articles by this author Manuela Constantini More articles by this author Robert Uzzo More articles by this author Alexander Kutikov More articles by this author David Chen More articles by this author Marc Smaldone More articles by this author Stephen Ryan More articles by this author Ahmet Bindayi More articles by this author James Porter More articles by this author Michael Liao More articles by this author Umberto Capitanio More articles by this author Alessandro Larcher More articles by this author Francesco Montorsi More articles by this author Clayton Lau More articles by this author Patrick Kilday More articles by this author Ken Jacobsohn More articles by this author Peter Langenstroer More articles by this author Peter Dietrich More articles by this author Ross Everett More articles by this author Prokar Dasgupta More articles by this author Nicolo de Luyk More articles by this author Ben Challacombe More articles by this author Andrea Minervini More articles by this author Andrea Mari More articles by this author Marco Carini More articles by this author Koon Rha More articles by this author Kidon Chang More articles by this author Riccardo Bertolo More articles by this author Alexandre Mottrie More articles by this author Geert De Naeyer More articles by this author Monish Aron More articles by this author Chandru Sundaram More articles by this author Jay Sulek More articles by this author Wesley White More articles by this author Luigi Schips More articles by this author Francesco Beradinelli More articles by this author Sisto Perdona More articles by this author Giuseppe Quarto More articles by this author Daniel Eun More articles by this author Matteo Ferro More articles by this author Francesco Porpiglia More articles by this author Lance Hampton More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...