1
|
Li Z, Huang Y, Wang X, Zhang M, Fan S, Liu F, Xiong S, Yang K, Guan H, Li X, Zhou L. Comparison of robot-assisted partial nephrectomy with KangDuo surgical system vs. the da Vinci Si system: Quality of life and medium-term oncological outcomes. Chin Med J (Engl) 2024:00029330-990000000-01254. [PMID: 39329291 DOI: 10.1097/cm9.0000000000003265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Indexed: 09/28/2024] Open
Affiliation(s)
- Zhihua Li
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing 100034, China
- Department of Nursing, Peking University First Hospital, Peking University, Beijing 100034, China
| | - Yiwei Huang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing 100034, China
| | - Xiang Wang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing 100034, China
| | - Meng Zhang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing 100034, China
- Department of Nursing, Peking University First Hospital, Peking University, Beijing 100034, China
| | - Shubo Fan
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing 100034, China
| | - Fan Liu
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing 100034, China
| | - Shengwei Xiong
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing 100034, China
| | - Kunlin Yang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing 100034, China
| | - Hua Guan
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing 100034, China
- Department of Nursing, Peking University First Hospital, Peking University, Beijing 100034, China
| | - Xuesong Li
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing 100034, China
| | - Liqun Zhou
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing 100034, China
| |
Collapse
|
2
|
Junker T, Duus L, Rasmussen BS, Azawi N, Lund L, Nørgaard B, Graumann O. Impact of Partial Nephrectomy and Percutaneous Cryoablation on Short-term Health-related Quality of Life—A Prospective Comparative Cohort Study. EUR UROL SUPPL 2022; 45:99-107. [PMID: 36353658 PMCID: PMC9637566 DOI: 10.1016/j.euros.2022.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2022] [Indexed: 11/06/2022] Open
Abstract
Background Partial nephrectomy (PN) is the gold standard for the treatment of stage cT1 renal cell carcinoma (RCC). However, the increasing incidence of RCC in the elderly population calls for alternative minimally invasive treatments to reduce the negative effects on patients’ health-related quality of life (HRQoL) and subsequent healthy life expectancy. Objective To assess and compare short-term HRQoL and self-reported health status after PN and percutaneous cryoablation (PCA) of patients treated for RCC stage cT1. Design, setting, and participants Patients who underwent PN or PCA between 2019 and 2021 for RCC stage cT1 at two university hospitals in Denmark were assessed. The exclusion criteria included insufficient understanding of the Danish language, dementia, metastatic RCC, conversion to nephrectomy, and salvage procedures. Intervention PN and PCA. Outcome measurements and statistical analysis The European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire was distributed before treatment, and 14 and 90 d postoperatively. A linear mixed-effect model was used to analyze the changes from baseline to follow-up between PN and PCA treatment. Results and limitations The cohort included 165 patients (PN: 79; PCA: 86). The completion rate was 96–98%. Patients receiving PCA were significantly older (median 69.1 vs 62.1 yr) and had lower scores on physical (p < 0.001) and role functioning (p = 0.009) than PN. A statistically significant change from baseline to 14 d was found for several HRQoL scales, which favored PCA over PN. However, the observed change was no longer significant at 90-d follow-up. Limitations include sample size and confounding by indication. Conclusions This study found a significant difference between baseline and 14-d follow-up in several HRQoL and symptoms scales, favoring PCA over PN. However, no significant differences were observed in any HRQoL scales between PN and PCA of RCC stage cT1 from baseline to 90-d follow-up. Patient summary Surgical removal and percutaneous cryoablation (freezing) of small tumors in the kidney had a similar impact on quality of life after 90 d.
Collapse
Affiliation(s)
- Theresa Junker
- Department of Radiology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern, Odense, Denmark
- Department of Urology, Odense University Hospital, Odense, Denmark
- Open Patient Data Explorative Network, Department of Clinical Research, University of Southern, Odense, Denmark
- Corresponding author at: Research and Innovation Unit of Radiology, UNIFY. Kløvervænget 10, Indgang 112, 5000 Odense, Denmark. Tel.: +45 2984 2169.
| | - Louise Duus
- Department of Radiology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern, Odense, Denmark
- Open Patient Data Explorative Network, Department of Clinical Research, University of Southern, Odense, Denmark
| | - Benjamin S.B. Rasmussen
- Department of Radiology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern, Odense, Denmark
- Open Patient Data Explorative Network, Department of Clinical Research, University of Southern, Odense, Denmark
| | - Nessn Azawi
- Department of Urology, Zealand University Hospital, Roskilde, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Lars Lund
- Department of Clinical Research, University of Southern, Odense, Denmark
- Department of Urology, Odense University Hospital, Odense, Denmark
- Open Patient Data Explorative Network, Department of Clinical Research, University of Southern, Odense, Denmark
| | - Birgitte Nørgaard
- Department of Public Health, University of Southern, Odense, Denmark
| | - Ole Graumann
- Department of Radiology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern, Odense, Denmark
- Open Patient Data Explorative Network, Department of Clinical Research, University of Southern, Odense, Denmark
| |
Collapse
|
3
|
Junker T, Duus L, Rasmussen BSB, Azawi N, Lund L, Graumann O, Nørgaard B. Quality of life and complications after nephron-sparing treatment of renal cell carcinoma stage T1-a systematic review. Syst Rev 2022; 11:4. [PMID: 34983648 PMCID: PMC8725354 DOI: 10.1186/s13643-021-01868-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 12/08/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Despite the fact that nephron-sparing treatment is considered preferable from a surgical perspective patients' quality of life (QoL) following different types of nephron-sparing treatments remains unclear. PURPOSE To investigate the quality of life and complications after nephron-sparing treatment of renal cell carcinomas of stage T1. MATERIALS AND METHODS A systematic search of six databases was carried out. We included studies that reported the quality of life and complications in patients aged 18 years or older following nephron-sparing treatment of renal cell carcinoma stage T1. The quality assessment was performed using the Critical Appraisal Skills Programme (CASP) checklist for cohort studies and the CASP Randomized Controlled Trial Checklist. Data were analyzed using a narrative approach. RESULTS Eight studies were included, six of which investigated QoL after partial nephrectomy and two after ablation therapies. Seven studies reported complications. Three studies reported higher QoL scores after partial nephrectomy compared to radical nephrectomy. Two studies showed that QoL increased or returned to baseline levels up to 12 months following partial nephrectomy. One study reported a gradual increase in QoL after radiofrequency ablation, and one study reported that all patients recovered to baseline QoL following cryoablation. Across studies, we found a complication rate up to 20% after partial nephrectomy and up to 12.5% after ablation therapy. CONCLUSIONS The results of this systematic review suggest that nephron-sparing treatment appears to be superior or comparable to other treatment alternatives with regard to QoL outcomes. Additionally, based on the studies included in this review, partial nephrectomy appears to have a higher complication rate compared with ablation therapies. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020155594.
Collapse
Affiliation(s)
- Theresa Junker
- Department of Radiology, Odense University Hospital, Kløvervænget 10, Indgang 112, 5000, Odense C, Denmark. .,Department of Clinical Research, University of Southern Denmark, Kløvervænget 10, Indgang 112, 5000, Odense C, Denmark.
| | - Louise Duus
- Department of Radiology, Odense University Hospital, Kløvervænget 10, Indgang 112, 5000, Odense C, Denmark.,Department of Clinical Research, University of Southern Denmark, Kløvervænget 10, Indgang 112, 5000, Odense C, Denmark
| | - Benjamin S B Rasmussen
- Department of Radiology, Odense University Hospital, Kløvervænget 10, Indgang 112, 5000, Odense C, Denmark.,Department of Clinical Research, University of Southern Denmark, Kløvervænget 10, Indgang 112, 5000, Odense C, Denmark
| | - Nessn Azawi
- Department of Urology, Zealand University Hospital, Sygehusvej 10, 4000, Roskilde, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Sygehusvej 10, 4000, Roskilde, Denmark
| | - Lars Lund
- Department of Clinical Research, University of Southern Denmark, Kløvervænget 10, Indgang 112, 5000, Odense C, Denmark.,Department of Urology, Odense University Hospital, J. B. Winsløws Vej 4, Odense C, 5000, Denmark
| | - Ole Graumann
- Department of Radiology, Odense University Hospital, Kløvervænget 10, Indgang 112, 5000, Odense C, Denmark.,Department of Clinical Research, University of Southern Denmark, Kløvervænget 10, Indgang 112, 5000, Odense C, Denmark
| | - Birgitte Nørgaard
- Department of Public Health, User Perspectives and Community-based Interventions, University of Southern Denmark, J.B. Winsløws Vej 9B, 5000, Odense C, Denmark
| |
Collapse
|
4
|
Beisland E, Hauge EM, Aarstad AKH, Hjermstad MJ, Aarstad HJ, Beisland C. Personality and educational level determine self-reported health-related quality-of-life and distress in patients with renal tumors awaiting radical surgery. Scand J Urol 2020; 54:304-312. [PMID: 32500779 DOI: 10.1080/21681805.2020.1773528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: Data on preoperative distress and health-related quality-of-life (HRQoL) is lacking for patients with newly diagnosed renal tumors. This study aims to compare HRQoL within this group with the general population and to study the relationship between distress, HRQoL, personality, coping, and patient/tumor-related factors.Materials and methods: Between January 2011 and June 2014, 153 patients (100 males/53 females), scheduled for surgery were prospectively included. Distress was determined by the General Health Questionnaire (GHQ), HRQoL by EORTC-QLQ-C30 questionnaire, personality by Eysenck Personality Inventory and coping by COPE questionnaire. HRQoL-data from an age and gender matched Norwegian reference population was used for comparison.Results: The study patients had significantly poorer HRQoL than the reference population. GHQ and HRQoL sum scores had a common variance (CV = r2) of 29-35%. In regression models, the measured variables accounted for 33% of the variance for the GHQ score. Significant predictors of the measured variance were neuroticism (18%), education level (3%) and avoidant coping (2%). Similarly, the measured variables accounted for 33-44% of the variance for the HRQoL sum scores. For all HRQoL sum scores, neuroticism predicted 17-28%, while education predicted 4-11% of the measured variance. Large tumor size, comorbidity, performance status and CRP predicted 2-7% of individual sum scores.Conclusions: For both preoperative distress and HRQoL, personality traits such as neuroticism and education level were the most important predictors. Tumor-related factors and other preexisting conditions seemed to be of lesser importance. Thus, preoperatively screening of psychological factors could be helpful to identify those at risk of poor outcomes.
Collapse
Affiliation(s)
- Elisabeth Beisland
- Department of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Elen M Hauge
- Department of Urology, Haukeland University Hospital, Bergen, Norway
| | | | - Marianne J Hjermstad
- Regional Advisory Unit in Palliative Care, Dept. of Oncology, Oslo University Hospital, Oslo, Norway.,European Palliative Care Research Centre (PRC), Dept. of Oncology, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Hans J Aarstad
- Department of Urology, Haukeland University Hospital, Bergen, Norway.,Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway
| | - Christian Beisland
- Department of Urology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| |
Collapse
|