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Alasker A, Alnafisah TR, Shafqat A, Sabbah BN, Alaswad M, Alghafees M, Alhaider A, Alsayyari A, Althonayan N, Al-Otaibi M, Ofisan SB, Alharbi MG, Alsaikhan B, Al-Khayal A. Nephrectomies in Saudi Arabia: A Comprehensive Analysis of Outcomes from a High-Volume Minimally Invasive Surgery Center. J Kidney Cancer VHL 2024; 11:1-12. [PMID: 39045259 PMCID: PMC11261389 DOI: 10.15586/jkcvhl.v11i3.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 07/08/2024] [Indexed: 07/25/2024] Open
Abstract
Literature reporting on the outcomes of the different procedures of nephrectomies (open vs laparoscopic vs robotic) in Saudi Arabia remains limited. Compare surgical and oncological outcomes between open and minimally invasive nephrectomies. A retrospective cohort study. The present study included all adult patients who underwent nephrectomies between January 1, 2015 and January 31, 2023. We collected demographic, preoperative, intraoperative, and postoperative data on 408 adult cancer patients who underwent nephrectomies at our center between January 2015 and January 2023. Statistical differences were calculated between procedure types. Overall survival was calculated using Kaplan-Meier curves with log-rank tests. P<0.05 was considered statistically significant. Measures of operative success (intraoperative blood loss, intraoperative and postoperative complications, and hospital stay) and oncological outcomes (local recurrence, metastatic progression, and chemotherapy use) between different procedure and nephrectomy types for cancer patients. A total of 408 cancer patients underwent nephrectomies. In cancer patients, open nephrectomy was associated with significantly higher intraoperative blood loss (p<0.001), incidence of blood transfusions (p<0.001), hospital stay (p<0.001), intraoperative complications (p=0.027 and p=0.001, respectively), local recurrence (p<0.001), metastatic progression (p=0.001), and chemotherapy (p=0.001) than minimally invasive surgery, but survival differences across procedure types were not statistically significant (log-rank p-value = 0.054). Regarding nephrectomy type, significant differences were observed in tumor size (p < 0.001), initial procedure type (p<0.001), operation time (p<0.001), blood transfusion (p=0.033), length of hospital stay (p=0.004), intraoperative complications (p=0.020), postoperative complications (p=0.025), Clavien classification (p=0.003), mortality (p=0.022), metastatic progression (p<0.001), and chemotherapy use (p=0.001) between simple/total nephrectomy, radical nephrectomy (RN), partial nephrectomy (PN), and nephroureterectomy. Survival differences between the four nephrectomy types were statistically significant (log-rank p value = 0.001). Minimally invasive nephrectomies reduce inpatient morbidity while conferring equivalent oncological and surgical outcomes.
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Affiliation(s)
- Ahmed Alasker
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
- Department of Urology, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia
- Department of Medicine, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Turki Rashed Alnafisah
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
| | - Areez Shafqat
- College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | - Belal Nedal Sabbah
- College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | - Marwan Alaswad
- College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | - Mohammad Alghafees
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
| | - Abdullah Alhaider
- Department of Urology, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia
| | | | - Naif Althonayan
- Department of Urology, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Mohammed Al-Otaibi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
| | - Salman Bin Ofisan
- College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
| | - Mohammed Ghazi Alharbi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
| | - Bader Alsaikhan
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
- Department of Urology, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia
- Department of Medicine, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Abdullah Al-Khayal
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
- Department of Urology, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia
- Department of Medicine, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia
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Alasker A, Alnafisah TR, Alghafees M, Shafqat A, Sabbah BN, Alhaider A, Alsayyari A, Althonayan N, AlOtaibi M, Ofisan SB, Alghamdi M, Albogami N, Al-Khayal A. Preserving Renal Function without Compromising Oncological Outcomes: A Comparative Study of Partial and Total Nephrectomies in T3 Stage Renal Cell Carcinoma. J Kidney Cancer VHL 2023; 10:28-32. [PMID: 38162464 PMCID: PMC10755761 DOI: 10.15586/jkcvhl.v10i4.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 12/01/2023] [Indexed: 01/03/2024] Open
Abstract
The utility of partial nephrectomy (PN) in locally advanced, stage T3 renal cell carcinoma (RCC) is controversial. This retrospective study aimed to review the oncological and functional outcomes of patients with T3a RCC who underwent PN. We included all patients with pT3a stage RCC undergoing either open, laparoscopic, or robotic PN at our center between January 2015 and 2023. A Wilcoxon rank sum test was utilized to compare nephrectomy types (radical nephrectomy [RN] vs PN). Survival analysis was conducted using Kaplan-Meier plots and a log-rank test. P-value < 0.05 indicated statistical significance. There were no significant differences in demographic characteristics between the RN and PN groups, except age (53.0 vs 6.5, respectively; P = 0.012) and body mass index (28.7 vs 34.3, respectively; P = 0.020). Furthermore, there were also no significant differences in the rates of local recurrence (P = 0.597), metastatic progression (P = 0.129), and chemotherapy use (P = 0.367) between nephrectomy types. Patient survival did not differ significantly based on the type of nephrectomy (log-rank P-value = 0.852). Together, our findings indicated that PN and RN yield near-equivalent oncological outcomes in terms of local recurrence, metastasis, and overall survival rates among pT3a RCC patients during a nearly 3-year follow-up period.
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Affiliation(s)
- Ahmed Alasker
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Department of Urology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- Department of Medicine, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Turki Rashed Alnafisah
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Mohammad Alghafees
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | | | - Abdullah Alhaider
- Department of Urology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | | | - Naif Althonayan
- Department of Urology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Mohammed AlOtaibi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Salman Bin Ofisan
- College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Mohammed Alghamdi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Nasser Albogami
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Department of Urology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- Department of Medicine, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Abdullah Al-Khayal
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Department of Urology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- Department of Medicine, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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