Real-world outcomes of patients with renal cell carcinoma, surgically treated at regional hospitals, based on a prospective long-term survey of the pre-robotic era.
Clinical T1
Prospective cohort
Radical nephrectomy
Regional hospital
Renal cancer
Renal function
Journal
International urology and nephrology
ISSN: 1573-2584
Titre abrégé: Int Urol Nephrol
Pays: Netherlands
ID NLM: 0262521
Informations de publication
Date de publication:
Apr 2023
Apr 2023
Historique:
received:
17
11
2022
accepted:
19
01
2023
pubmed:
14
2
2023
medline:
24
3
2023
entrez:
13
2
2023
Statut:
ppublish
Résumé
Renal cancer surgery is frequently performed in small regional hospitals in Japan. This study evaluated the outcomes of renal cancer surgery, comparing results from the pre-robotic surgery era with those obtained with robotic surgery. This prospective cohort study was conducted on patients who underwent renal cancer surgery between 2008 and 2013 at 14 hospitals, comprising 13 regional hospitals and a university hospital, registered in the Tohoku Urological Evidence-Based Medicine Study Group. The patients' backgrounds; perioperative data; annual postoperative renal function; and prognostic surveys, performed over a median follow-up period of 10 years were obtained. In 930 surgical cases at the 14 registered hospitals, the 10-year recurrence-free survival rates of cT1a, cT1b, cT2, and cT3 were 0.9326, 0.8501, 0.5786, and 0.5101, respectively. Meanwhile, the 10-year overall survival rates were 0.9612, 0.8662, 0.7505, and 0.7209, respectively. Long-term observation in patients with cT1 showed that vessel involvement and high tumor grade were prognostic factors for recurrence. As a noteworthy fact, radical nephrectomy was performed in 53.3% of patients with cT1a at the regional hospitals. However, even in patients with preoperative chronic kidney disease stage 3, radical nephrectomy was not a prognostic factor of renal function. This indicates that compensatory mechanisms had been working for a long time in many patients who underwent radical nephrectomies without hypertension and preoperative proteinuria, which were predictors of end-stage renal disease. Based on a prospective long-term survey of the pre-robotic era, our results suggested no difference of the survival outcomes between the university hospital and regional hospitals. Our study provides baseline data to evaluate the outcomes of renal cancer robotic surgery, performed at regional hospitals.
Identifiants
pubmed: 36781679
doi: 10.1007/s11255-023-03477-5
pii: 10.1007/s11255-023-03477-5
pmc: PMC10030418
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
875-882Subventions
Organisme : Grants-in-Aid for Scientific Research from the Japanese Ministry of Education, Culture, Sports, Science and Technology
ID : 20K07582
Organisme : Grants-in-Aid for Scientific Research from the Japanese Ministry of Education, Culture, Sports, Science and Technology
ID : K426462393
Informations de copyright
© 2023. The Author(s).
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