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Current Oncology
Volume 30
Issue 1
10.3390/curroncol30010092
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Article

Purely Off-Clamp Laparoscopic Partial Nephrectomy Stands the Test of Time: 15 Years Functional and Oncologic Outcomes from a Single Center Experience

by
Aldo Brassetti
1,*,
Umberto Anceschi
1,
Alfredo Maria Bove
1,
Francesco Prata
1,
Manuela Costantini
1,
Mariaconsiglia Ferriero
1,
Riccardo Mastroianni
1,
Leonardo Misuraca
1,
Gabriele Tuderti
1,
Giulia Torregiani
2,
Marco Covotta
2,
Michele Gallucci
1 and
Giuseppe Simone
1
1
Department of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy
2
Department of Anesthesiology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2023, 30(1), 1196-1205; https://doi.org/10.3390/curroncol30010092
Submission received: 27 December 2022 / Revised: 9 January 2023 / Accepted: 12 January 2023 / Published: 15 January 2023
(This article belongs to the Special Issue Radical Surgery Advances in Oncology)
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Abstract

Background: Nephron-sparing surgery represents the gold standard treatment for organ-confined renal tumors. We present 15-years of outcomes after off-clamp laparoscopic partial nephrectomy (ocLPN). Methods: a retrospective analysis was performed on patients who underwent ocLPN between May 2001 and December 2005. Baseline demographic, clinical, pathologic, surgical, functional and survival data were collected. The Kaplan–Meier method evaluated group-specific oncologic outcomes at 5, 10 and 15 years and the log rank test assessed differences between groups. The same analysis investigated the probabilities of developing a significant renal function impairment (sRFI) and achieving ROMeS. Cox analyses identified predictors of this latter tricomposite outcome. Results: We included 63 patients whose median tumor size was 3 cm (IQR:2–4). At 15 years, the chances of developing local recurrence, metachronous renal cancers or distant metastases were 2 ± 2%, 23 ± 6% and 17 ± 5%, respectively. Consequently, disease-free, cancer-specific and overall-survival probabilities were 68 ± 6%, 90 ± 4% and 72 ± 6%. MCRSS and UCISS well predicted oncologic outcomes. Overall, nine (14%) patients experienced an sRFI and 33 (52%) achieved ROMeS. Age (HR: 1.046; p = 0.033) and malignant histology (low-risk cancers HR: 3.233, p = 0.048) (intermediate/high risk cancers HR: 5.721, p = 0.023) were independent predictors of ROMeS non-achievement. Conclusions: At 15 years from ocLPN, most of patients will experience both excellent functional and oncologic outcomes.
Keywords: laparoscopy; long term outcomes; partial nephrectomy; renal cancer; survival laparoscopy; long term outcomes; partial nephrectomy; renal cancer; survival

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MDPI and ACS Style

Brassetti, A.; Anceschi, U.; Bove, A.M.; Prata, F.; Costantini, M.; Ferriero, M.; Mastroianni, R.; Misuraca, L.; Tuderti, G.; Torregiani, G.; et al. Purely Off-Clamp Laparoscopic Partial Nephrectomy Stands the Test of Time: 15 Years Functional and Oncologic Outcomes from a Single Center Experience. Curr. Oncol. 2023, 30, 1196-1205. https://doi.org/10.3390/curroncol30010092

AMA Style

Brassetti A, Anceschi U, Bove AM, Prata F, Costantini M, Ferriero M, Mastroianni R, Misuraca L, Tuderti G, Torregiani G, et al. Purely Off-Clamp Laparoscopic Partial Nephrectomy Stands the Test of Time: 15 Years Functional and Oncologic Outcomes from a Single Center Experience. Current Oncology. 2023; 30(1):1196-1205. https://doi.org/10.3390/curroncol30010092

Chicago/Turabian Style

Brassetti, Aldo, Umberto Anceschi, Alfredo Maria Bove, Francesco Prata, Manuela Costantini, Mariaconsiglia Ferriero, Riccardo Mastroianni, Leonardo Misuraca, Gabriele Tuderti, Giulia Torregiani, and et al. 2023. "Purely Off-Clamp Laparoscopic Partial Nephrectomy Stands the Test of Time: 15 Years Functional and Oncologic Outcomes from a Single Center Experience" Current Oncology 30, no. 1: 1196-1205. https://doi.org/10.3390/curroncol30010092

APA Style

Brassetti, A., Anceschi, U., Bove, A. M., Prata, F., Costantini, M., Ferriero, M., Mastroianni, R., Misuraca, L., Tuderti, G., Torregiani, G., Covotta, M., Gallucci, M., & Simone, G. (2023). Purely Off-Clamp Laparoscopic Partial Nephrectomy Stands the Test of Time: 15 Years Functional and Oncologic Outcomes from a Single Center Experience. Current Oncology, 30(1), 1196-1205. https://doi.org/10.3390/curroncol30010092

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