Management of high complexity renal masses in partial nephrectomy: A multicenter analysis.
Nephrometry; Partial Nephrectomy; RENAL score; Renal cell carcinoma; Trifecta
OBJECTIVE: To determine the safety and efficacy of performing partial nephrectomy (PN) on patients with high nephrometry score tumors.
PATIENTS AND METHODS: We used a prospectively maintained multi-institutional kidney cancer database to identify 144 patients with R.E.N.A.L. nephrometry score ≥10 who underwent PN for a cT1-cT2 renal mass. Baseline demographics and clinical characteristics, tumor characteristics, perioperative, and pathological outcomes were analyzed and reported. Trifecta achievement, defined by warm ischemia time <25 >minutes, no perioperative complications, and negative surgical margins, was the primary outcome. We assessed the relationship of baseline clinical and tumor characteristics data to trifecta achievement and perioperative complications.
RESULTS: Baseline median eGFR was 84.57 ml/min/1.73 m
CONCLUSION: In treating complex renal tumors, PN should be performed when possible. Although this remains a challenging procedure, with experience and appropriate case selection, the trifecta outcome can be achieved in a significant number of patients with high renal score lesions.
Kidney & Diabetes
Beksac, Alp Tuna; Okhawere, Kennedy E; Elbakry, Amr A; Dayal, Bheesham D; Paulucci, David J; Rothberg, Michael B; Sfakianos, John P; Abaza, Ronney; Eun, Daniel D; Bhandari, Akshay; Hemal, Ashok K; Porter, James R; and Badani, Ketan K, "Management of high complexity renal masses in partial nephrectomy: A multicenter analysis." (2019). Articles, Abstracts, and Reports. 1652.