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Open versus laparoscopic partial nephrectomy for clinical T1a renal masses: a matched-pair comparison of 280 patients with TRIFECTA outcomes (RECORd Project)

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Abstract

Aim of the study

To report a matched-pair comparative analysis between open (OPN) and laparoscopic partial nephrectomy (LPN) for clinical (c) T1a renal masses from a large prospective multicenter dataset.

Materials and methods

The RECORd Project includes all patients who underwent OPN and LPN for kidney cancer between January 2009 and January 2011 at 19 Italian centers. Open and laparoscopic groups were compared regarding clinical, surgical, pathologic, functional results and TRIFECTA outcome. Multivariable logistic regression models were used to analyze predictors of WIT >25 min, surgical complications (SC) and the achievement of the TRIFECTA outcome.

Results

Overall, 301 patients had OPN and 149 LPN. Groups were matched 1:1 (140 matched pairs) for clinical diameter, tumor location and type of indication. Laparoscopic partial nephrectomy was associated with a significantly mean longer WIT (19.9 vs. 15.1 min; p < 0.001), and it was an independent predictor of a WIT >25 min (RR 6.29, p < 0.0001). The TRIFECTA was achieved in 78.6 and 74.3 % after OPN and LPN (p = ns), respectively, and the surgical approach was not a predictor of a negative TRIFECTA and SC at multivariable analysis. At 6-month follow-up, no significant differences were observed between the OPN and LPN group both in estimated glomerular filtration rate (eGFR) (∆GFR 1.1 vs. 4.1 mL/min) and in new-onset stage III–V chronic kidney disease (CKD) rate (0 vs. 0.7 %).

Conclusion

No significant difference in achieving the TRIFECTA outcome was reported after OPN and LPN. LPN was associated with a significantly longer WIT. However, eGFR at 6-month follow-up did not differ significantly between the two surgical approaches.

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Authors and Affiliations

  1. Clinica Urologica I, AOUC, Università di Firenze, Florence, Italy

    Andrea Minervini, Giampaolo Siena, Andrea Mari, Marco Carini & Sergio Serni

  2. Unità Operativa di Urologia Dipartimento di NefroUrologia, Azienda AO Spedali Civili di Brescia, Brescia, Italy

    Alessandro Antonelli, Sergio Cosciani Cunico & Claudio Simeone

  3. Policlinico di Modena, Clinica Urologica, Università di Modena, Modena, Italy

    Giampaolo Bianchi

  4. Dipartimento Chirurgico Polispecialistico, Urologia, Azienda Ospedaliera Ospedale Niguarda Ca’ Granda, Milan, Italy

    Aldo Massimo Bocciardi

  5. Clinica Urologica, Università di Padova, Padua, Italy

    Vincenzo Ficarra

  6. Divisione di Urologia, Università di Torino, Ospedale San Luigi Gonzaga, Orbassano, Torino, Italy

    Cristian Fiori & Francesco Porpiglia

  7. Policlinico Federico II, Università di Napoli, Naples, Italy

    Ferdinando Fusco & Vincenzo Mirone

  8. Dipartimento di Urologia, Università di Bologna, Ospedale S. Orsola-Malpighi, Bologna, Italy

    Giuseppe Martorana & Riccardo Schiavina

  9. Ospedale Sestri Levante, Sestri Levante, Italy

    Mauro Medica

  10. Luna Foundation, Rome, Italy

    Giuseppe Morgia

  11. UOC Urologia Ospedale Maggiore Ca’ Granda Policlinico Mangiagalli Regina Elena Università degli Studi di Milano, Milan, Italy

    Francesco Rocco

  12. I.R.C.C.S. Policlinico San Matteo, Struttura Di Urologia, Pavia, Italy

    Bruno Rovereto

  13. Dipartimento di Urologia, Azienda Ospedaliera Maggiore Della Carità, Università del Piemonte Orientale, Novara, Italy

    Carlo Terrone & Alessandro Volpe

Authors
  1. Andrea Minervini
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  2. Giampaolo Siena
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  3. Alessandro Antonelli
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  4. Giampaolo Bianchi
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  5. Aldo Massimo Bocciardi
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  6. Sergio Cosciani Cunico
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  7. Vincenzo Ficarra
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  8. Cristian Fiori
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  9. Ferdinando Fusco
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  10. Andrea Mari
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  11. Giuseppe Martorana
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  12. Mauro Medica
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  13. Vincenzo Mirone
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  14. Giuseppe Morgia
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  15. Francesco Porpiglia
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  16. Francesco Rocco
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  17. Bruno Rovereto
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  18. Riccardo Schiavina
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  19. Claudio Simeone
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  20. Carlo Terrone
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  21. Alessandro Volpe
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  22. Marco Carini
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  23. Sergio Serni
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and Members of the RECORd Project-LUNA Foundation

Corresponding author

Correspondence to Giampaolo Siena.

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Minervini, A., Siena, G., Antonelli, A. et al. Open versus laparoscopic partial nephrectomy for clinical T1a renal masses: a matched-pair comparison of 280 patients with TRIFECTA outcomes (RECORd Project). World J Urol 32, 257–263 (2014). https://doi.org/10.1007/s00345-013-1155-7

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  • DOI: https://doi.org/10.1007/s00345-013-1155-7

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