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Nandanan N, Veccia A, Antonelli A, Derweesh I, Mottrie A, Minervini A, Aron M, Simone G, Capitanio U, Simeone C, Eun D, Perdonà S, Porter J, Sundaram C, Zhang C, Uzzo R, Challacombe B, Hampton LJ, Kaouk J, Porpiglia F, Autorino R. Outcomes and predictors of benign histology in patients undergoing robotic partial or radical nephrectomy for renal masses: a multicenter study. Cent European J Urol 2020; 73:33-38. [PMID: 32395320 PMCID: PMC7203778 DOI: 10.5173/ceju.2020.0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 02/09/2020] [Accepted: 03/01/2020] [Indexed: 11/22/2022] Open
Abstract
Introduction Theaim of this study was to assess preoperative factors associated with benign histology in patients undergoing surgical removal of a renal mass and to analyze outcomes of robotic partial nephrectomy (PN) and radical nephrectomy (RN) for these masses. Material and methods Overall, 2,944 cases (543 benign and 2,401 malignant) who underwent robotic PN and RN between 2003–2018 at 10 institutions worldwide were included. The assessment of the predictors of benign histology was made at the final surgical pathology report. Descriptive statistics, Mann-Whitney U, Pearson’s χ2, and logistic regression analysis were used. Results Patients in the benign group were mostly female (61 vs. 33%; p <0.001), with lower body mass index (BMI) (26.0 vs. 27.1 kg/m2; p <0.001). The benign group presented smaller tumor size (2.8 vs. 3.5 cm; p <0.001), R.E.N.A.L. score (6.0 vs. 7.0; p <0.001). There was a lower rate of hilar (11 vs.18%; p = 0.001), cT≥3 (1 vs. 4.5%; p <0.001) tumors in the benign group. There was a statistically significant higher rate of PN in the benign group (97 vs. 86%; p <0.001) as well as a statistically significant lower 30-day re-admission rate (2 vs. 5%; p = 0.081). Multivariable analysis showed male gender (OR: 0.52; p <0.001), BMI (OR: 0.95; p <0.001), and cT3a (OR: 0.22; p = 0.005) to be inversely associated to benign histology. Conclusions In 18% of cases, a benign histologic type was found. Only 3% of these tumors were treated with RN. Female gender, lower BMI, and higher T staging showed to be independent predictors of benign histology.
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Affiliation(s)
- Naveen Nandanan
- Division of Urology, Virginia Commonwealth University Health System, Richmond, VA, USA.,equal contributions
| | - Alessandro Veccia
- Division of Urology, Virginia Commonwealth University Health System, Richmond, VA, USA.,Urology Unit, ASST SpedaliCivili Hospital, Brescia, Italy, Department of Medical and Surgical Specialties, Radiological Science, and Public Health, University of Brescia, Italy.,equal contributions
| | - Alessandro Antonelli
- Urology Unit, ASST SpedaliCivili Hospital, Brescia, Italy, Department of Medical and Surgical Specialties, Radiological Science, and Public Health, University of Brescia, Italy
| | - Ithaar Derweesh
- Department of Urology, UCSD Health System, La Jolla, CA, USA
| | | | - Andrea Minervini
- Department of Urology, University of Florence, Careggi Hospital, Firenze, Italy
| | - Monish Aron
- Center for Robotic Simulation and Education, USC Institute of Urology, Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Giuseppe Simone
- Department of Urology, 'Regina Elena' National Cancer Institute, Rome, Italy
| | - Umberto Capitanio
- Unit of Urology, Division of Experimental Oncology, Urological Research Institute (URI), IRCCS Ospedale San Raffaele, Milan, Italy
| | - Claudio Simeone
- Urology Unit, ASST SpedaliCivili Hospital, Brescia, Italy, Department of Medical and Surgical Specialties, Radiological Science, and Public Health, University of Brescia, Italy
| | - Daniel Eun
- Department of Urology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Sisto Perdonà
- Urology Unit, G. Pascale Foundation IRCS, Naples, Italy
| | | | - Chandru Sundaram
- Division of Urology, Virginia Commonwealth University Health System, Richmond, VA, USA
| | - Chao Zhang
- Department of Urology, Changhai Hospital, Shanghai, China
| | - Robert Uzzo
- Division of Urology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | | | - Lance J Hampton
- Division of Urology, Virginia Commonwealth University Health System, Richmond, VA, USA
| | - Jihad Kaouk
- Department of Urology, Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Francesco Porpiglia
- Division of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | - Riccardo Autorino
- Division of Urology, Virginia Commonwealth University Health System, Richmond, VA, USA
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