Nephron Sparing Treatment (NEST) for Small Renal Masses: A Feasibility Cohort-embedded Randomised Controlled Trial Comparing Percutaneous Cryoablation and Robot-assisted Partial Nephrectomy.

Humans Robotic Surgical Procedures / adverse effects Robotics Cryosurgery / adverse effects Feasibility Studies Nephrectomy / adverse effects Kidney Neoplasms / surgery Nephrons / pathology Treatment Outcome Retrospective Studies Randomized Controlled Trials as Topic
Cryoablation Cryotherapy Kidney cancer Partial nephrectomy T1a tumour Thermal ablation

Journal

European urology
ISSN: 1873-7560
Titre abrégé: Eur Urol
Pays: Switzerland
ID NLM: 7512719

Informations de publication

Date de publication:
Apr 2024
Historique:
received: 29 03 2023
revised: 22 06 2023
accepted: 19 07 2023
medline: 18 3 2024
pubmed: 9 9 2023
entrez: 8 9 2023
Statut: ppublish

Résumé

There is a paucity of high-level evidence on small renal mass (SRM) management, as previous classical randomised controlled trials (RCTs) failed to meet accrual targets. Our objective was to assess the feasibility of recruitment to a cohort-embedded RCT comparing cryoablation (CRA) to robotic partial nephrectomy (RPN). A total of 200 participants were recruited to the cohort, of whom 50 were enrolled in the RCT. In the CRA intervention arm, 84% consented (95% confidence interval [CI] 64-95%) and 76% (95% CI 55-91%) received CRA; 100% (95% CI 86-100%) of the control arm underwent RPN. The retention rate was 90% (95% CI 79-96%) at 6 mo. In the RPN group 2/25 (8%) were converted intra-operative to radical nephrectomy. Postoperative complications (Clavien-Dindo grade 1-2) occurred in 12% of the CRA group and 29% of the RPN group. The median length of hospital stay was shorter for CRA (1 vs 2 d; p = 0.019). At 6 mo, the mean change in renal function was -5.0 ml/min/1.73 m

Identifiants

DOI: 10.1016/j.eururo.2023.07.012 PMID: 37684178
pubmed: 37684178
pii: S0302-2838(23)03012-9
doi: 10.1016/j.eururo.2023.07.012
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

333-336

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.

Auteurs

Joana B Neves (JB)

Division of Surgery and Interventional Sciences, University College London, London, UK; Specialist Centre for Kidney Cancer, Royal Free Hospital, London, UK.

Hannah Warren (H)

Division of Surgery and Interventional Sciences, University College London, London, UK; Specialist Centre for Kidney Cancer, Royal Free Hospital, London, UK.

Joseph Santiapillai (J)

Division of Surgery and Interventional Sciences, University College London, London, UK; Specialist Centre for Kidney Cancer, Royal Free Hospital, London, UK.

Nicola Rode (N)

Specialist Centre for Kidney Cancer, Royal Free Hospital, London, UK.

David Cullen (D)

Specialist Centre for Kidney Cancer, Royal Free Hospital, London, UK.

Menelaos Pavlou (M)

Department of Statistical Science, University College London, London, UK.

Miles Walkden (M)

Specialist Centre for Kidney Cancer, Royal Free Hospital, London, UK; Department of Interventional Radiology, University College London Hospital, London, UK.

Prasad Patki (P)

Specialist Centre for Kidney Cancer, Royal Free Hospital, London, UK.

Ravi Barod (R)

Division of Surgery and Interventional Sciences, University College London, London, UK; Specialist Centre for Kidney Cancer, Royal Free Hospital, London, UK.

Faiz Mumtaz (F)

Division of Surgery and Interventional Sciences, University College London, London, UK; Specialist Centre for Kidney Cancer, Royal Free Hospital, London, UK.

Michael Aitchison (M)

Specialist Centre for Kidney Cancer, Royal Free Hospital, London, UK.

Steven Bandula (S)

Department of Interventional Radiology, University College London Hospital, London, UK.

Elena Pizzo (E)

Department of Allied Health Research, University College London, London, UK.

Veronica Ranieri (V)

Clinical Psychology, Tavistock and Portman Foundation Trust, London, UK.

Norman Williams (N)

Division of Surgery and Interventional Sciences, University College London, London, UK.

William Wildgoose (W)

Patient Representative, London, UK.

Kurinchi Gurusamy (K)

Division of Surgery and Interventional Sciences, University College London, London, UK.

Mark Emberton (M)

Division of Surgery and Interventional Sciences, University College London, London, UK; Department of Urology, University College London Hospital, London, UK.

Axel Bex (A)

Division of Surgery and Interventional Sciences, University College London, London, UK; Specialist Centre for Kidney Cancer, Royal Free Hospital, London, UK.

Maxine G B Tran (MGB)

Division of Surgery and Interventional Sciences, University College London, London, UK; Specialist Centre for Kidney Cancer, Royal Free Hospital, London, UK. Electronic address: m.tran@ucl.ac.uk.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Nephron Sparing Treatment (NEST) for Small...
questionsmedicales.fr › Technologie, industrie et agriculture › Technologie › Automatisation › Interventions chirurgicales robotisées › Nephron Sparing Treatment (NEST) for Small...
questionsmedicales.fr › Sciences de l'information › Méthodologies informatiques › Algorithmes › Intelligence artificielle › Robotique › Nephron Sparing Treatment (NEST) for Small...
questionsmedicales.fr › Procédures de chirurgie opératoire › Techniques d'ablation › Cryochirurgie › Nephron Sparing Treatment (NEST) for Small...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études de faisabilité › Nephron Sparing Treatment (NEST) for Small...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie urogénitale › Procédures de chirurgie urologique › Néphrectomie › Nephron Sparing Treatment (NEST) for Small...
questionsmedicales.fr › Maladies urogénitales › Maladies urologiques › Tumeurs urologiques › Tumeurs du rein › Nephron Sparing Treatment (NEST) for Small...
questionsmedicales.fr › Appareil urogénital › Voies urinaires › Rein › Néphrons › Nephron Sparing Treatment (NEST) for Small...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Nephron Sparing Treatment (NEST) for Small...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Nephron Sparing Treatment (NEST) for Small...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études cliniques comme sujet › Essais cliniques comme sujet › Essais cliniques contrôlés comme sujet › Essais contrôlés randomisés comme sujet › Nephron Sparing Treatment (NEST) for Small...