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- W2088457037 abstract "You have accessJournal of UrologyKidney Cancer: Surgical Therapy IV1 Apr 2015MP63-06 TRIFECTA OUTCOMES OF ROBOTIC PARTIAL NEPHRECTOMY FOR T1B RENAL MASSES: A MULTI-INSTITUTIONAL ANALYSIS Homayoun Zargar, Craig Rogers, Sam Bhayani, Mohamad Allaf, Jeffrey A. Larson, Ravi Barod, Alon Mass, Michael H. Johnson, Michael Stifelman, and Jihad H. Kaouk Homayoun ZargarHomayoun Zargar More articles by this author , Craig RogersCraig Rogers More articles by this author , Sam BhayaniSam Bhayani More articles by this author , Mohamad AllafMohamad Allaf More articles by this author , Jeffrey A. LarsonJeffrey A. Larson More articles by this author , Ravi BarodRavi Barod More articles by this author , Alon MassAlon Mass More articles by this author , Michael H. JohnsonMichael H. Johnson More articles by this author , Michael StifelmanMichael Stifelman More articles by this author , and Jihad H. KaoukJihad H. Kaouk More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2338AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The trifecta of oncology, complications and functional outcome has been proposed as a measure of effectiveness of robotic partial nephrectomy (RPN) in the treatment of small renal masses. The utility of trifecta for the assessment of outcomes of larger renal tumors has not been well studied. Our aim was to assess the rate of trifecta of outcomes in cases of RPN for T1b renal tumors, in a large multi-institutional series. METHODS We retrospectively reviewed records of 1836 cases of RPN performed in 5 high volume centres across USA from 2000 to mid 2014. We limited our study to RPN for T1b renal masses (> 4cm and ≤ 7 cm). Tumor complexity was assigned according to R.E.N.A.L nephrometry score. Tumors were further divided into simple (4-6), intermediate (7-9) and complex (10-12) groups. We defined the Trifecta as negative surgical margin, zero perioperative complications and warm ischemia time of ≤ 25 minutes. Multivariable regression analysis of factors predicting trifecta (tumor size, R.E.N.A.L nephrometry score, experience with RPN, Charlson comorbidity score, preoperative GFR and body mass index) was performed. RESULTS Total of 319 patients met our inclusion criteria. The median age of the cohort was 61 yrs. (IQR 51-69) and the median tumor nephrometry score was 9 (IQR 7-9) with 72 (22.6%) of the tumors classified as complex. The median warm ischemia time was 23 min with overall complication rate of 17.2% and positive margin rate of 2.5%. The rate of achievement of trifecta rate was 43.6%. On multivariable analysis increase in cumulative RPN experience (OR=1.18 ;95%CI (1.01-1.39)) and increase in tumor complexity score (OR =0.80; 95%CI (0.67-0.97)) were predictors of achieving Trifecta. CONCLUSIONS The rate of trifecta for T1b renal tumors is lower than reported rate for T1a tumors. Renal nephrometry score and surgeon's experience with RPN were predictors of achieving trifecta for T1b tumors in our cohort. Although Trifecta does not incorporate the long-term functional outcome of nephron sparing surgery, it provides us with an immediate surrogate for surgical quality. Longitudinal functional and oncological follow up data is required to validate utility of trifecta as a surrogate for long-term outcomes. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e790-e791 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Homayoun Zargar More articles by this author Craig Rogers More articles by this author Sam Bhayani More articles by this author Mohamad Allaf More articles by this author Jeffrey A. Larson More articles by this author Ravi Barod More articles by this author Alon Mass More articles by this author Michael H. Johnson More articles by this author Michael Stifelman More articles by this author Jihad H. Kaouk More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ..." @default.
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- W2088457037 title "MP63-06 TRIFECTA OUTCOMES OF ROBOTIC PARTIAL NEPHRECTOMY FOR T1B RENAL MASSES: A MULTI-INSTITUTIONAL ANALYSIS" @default.
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