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Robot-assisted partial nephrectomy in younger versus older adults with renal cell carcinoma: a propensity score-matched analysis

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Abstract

Purpose

Our study aimed to compare the surgical outcomes of robot-assisted partial nephrectomy (RAPN) between younger and older patients after adjusting for their background differences. We particularly assessed RAPN outcomes and safety in older patients.

Methods

We retrospectively evaluated 559 patients clinically diagnosed with T1 renal cell carcinoma (RCC) and treated with RAPN between 2013 and 2022 at five institutions in Japan. The patients were classified into two groups according to their age during surgery (younger group: < 75 years, older group: ≥ 75 years). Propensity score matching (PSM) was performed to adjust for the differences in the backgrounds between younger and older patients, and surgical outcomes were compared.

Results

Among the 559 patients, 422 (75.5%) and 137 (24.5%) were classified into the younger and older groups, respectively; 204 and 102 patients from the younger and older groups were matched according to PSM, respectively. Subsequently, patient characteristics other than age were not significantly different between the two groups. In the matched cohort, the older group had more patients with major complications (younger, 3.0%; older, 8.8%; P = 0.045).

Conclusion

Surgical outcomes of RAPN in older patients with RCC were comparable with those in younger patients, although older patients experiencedsignificantly more complications than younger patients. These results suggest the need for further detailed preoperative evaluation and appropriate postoperative management in older patients receiving RAPN.

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Availability of data and material

The corresponding author can be contacted regarding the use of the data. The data are not publicly available.

Code availability

A software application has been used for the code.

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Authors and Affiliations

  1. Department of Urology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15, Kuramoto-cho, Tokushima, 770-8503, Japan

    Ryotaro Tomida, Tomoya Fukawa, Yoshito Kusuhara, Hiro-omi Kanayama & Masayuki Takahashi

  2. Japanese Red Cross Kochi Hospital, Kochi, Japan

    Keisuke Hashimoto & Takushi Naroda

  3. Tokushima Prefectural Central Hospital, Tokushima, Japan

    Keito Shiozaki & Hirofumi Izaki

  4. Takamatsu Red Cross Hospital, Takamatsu, Japan

    Kazuyoshi Izumi & Yasuo Kawanishi

  5. Ehime Prefectural Central Hospital, Matsuyama, Japan

    Iku Ninomiya, Fumiya Kadoriku & Kenjiro Okamoto

Authors
  1. Ryotaro Tomida
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  2. Tomoya Fukawa
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  3. Yoshito Kusuhara
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  14. Masayuki Takahashi
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Contributions

Data curation, analysis, and manuscript writing: Ryotaro Tomida. Data collection: Ryotaro Tomida, Tomoya Fukawa, Keisuke Hashimoto, Keito Shiozaki, Kazuyoshi Izumi, Iku Ninomiya and Fumiya Kadoriku. Conceptualization and Methodology: Ryotaro Tomida and Tomoya Fukawa. Supervision: Tomoya Fukawa. Wrote the original draft of the manuscript: Ryotaro Tomida. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Tomoya Fukawa.

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Conflict of interest

The authors declare no potential conflict of interest.

Ethics approval

This study was approved by the Ethics Committee of the Tokushima University Hospital and the Institutional Review Board of each institution (Reference Protocol ID: 4170).

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An opt-out approach was used to obtain informed consent from patients.

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Tomida, R., Fukawa, T., Kusuhara, Y. et al. Robot-assisted partial nephrectomy in younger versus older adults with renal cell carcinoma: a propensity score-matched analysis. World J Urol 42, 326 (2024). https://doi.org/10.1007/s00345-024-04917-2

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  • DOI: https://doi.org/10.1007/s00345-024-04917-2

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