Department of Urology and School of Medicine, Fujita Health University, Toyoake, Japan.
Department of Radiology, School of Medicine, Fujita Health University, Toyoake, Japan.
J Endourol. 2021 Jul;35(7):1006-1012. doi: 10.1089/end.2020.0994. Epub 2021 Jan 6.
To evaluate the outcomes of robot-assisted partial nephrectomy (RAPN) in cystic renal tumors. We retrospectively analyzed patients who underwent RAPN for either cystic ( = 46) or solid ( = 271) renal tumors at Fujita Health University between 2010 and 2019. Cystic renal tumors were diagnosed using cross-sectional imaging. Perioperative, oncologic, and functional outcomes were assessed. The median follow-up periods were 38, 41, and 37 months in the total, cystic, and solid groups, respectively. Most patient characteristics were similar among both groups, while the median age of the cystic group was significantly lower than that of the solid group ( = 0.02). Most perioperative variables and complications were comparable between the two groups. There was no significant difference between the groups in perioperative renal function. The estimated glomerular filtration rate preservation rates were 93.1% and 89.2% in the cystic and solid groups, respectively ( = 0.17). The cystic group showed a higher benign histology rate (19.6% 7%) and lower Fuhrman grade than the solid group (24.3% 15.1% in grade 1, and 73% 81.3% in grade 2), although there was no statistically significant difference between the two groups. In the solid group, 10 patients (3.7%) experienced recurrence, and 2 patients (0.7%) died of renal-cell carcinoma, while none of the patients with cystic tumors experienced recurrence. There was no statistically significant difference between the cystic and solid tumors with respect to 5-year recurrence-free survival ( = 0.18), cancer-specific survival ( = 0.55), and overall survival ( = 0.35). RAPN for cystic renal tumors appears to be safe and feasible with perioperative, long-term functional and oncologic outcomes comparable with those in solid tumors. RAPN can be a safe and effective surgical option for cystic renal tumors.
评估机器人辅助部分肾切除术(RAPN)治疗囊性肾肿瘤的疗效。我们回顾性分析了 2010 年至 2019 年期间在藤田保健卫生大学接受 RAPN 治疗的囊性( = 46 例)或实体性( = 271 例)肾肿瘤患者的临床资料。囊性肾肿瘤通过影像学检查确诊。评估围手术期、肿瘤学和功能结局。总组、囊性组和实体组的中位随访时间分别为 38、41 和 37 个月。两组患者的大多数特征相似,而囊性组的中位年龄明显低于实体组( = 0.02)。两组的大多数围手术期变量和并发症相似。两组患者围手术期肾功能无显著差异。囊性组和实体组的估计肾小球滤过率保留率分别为 93.1%和 89.2%( = 0.17)。囊性组良性组织学比例(19.6% 比 7%)和 Fuhrman 分级(1 级 24.3% 比 15.1%,2 级 73% 比 81.3%)均低于实体组,但两组间无统计学差异。在实体组中,10 例(3.7%)患者复发,2 例(0.7%)患者死于肾细胞癌,而囊性肿瘤患者无一例复发。两组患者的 5 年无复发生存率( = 0.18)、癌症特异性生存率( = 0.55)和总生存率( = 0.35)无统计学差异。RAPN 治疗囊性肾肿瘤安全可行,围手术期、长期肾功能和肿瘤学结局与实体肿瘤相当。RAPN 可为囊性肾肿瘤提供一种安全有效的手术选择。