Vartolomei Mihai Dorin, Remzi Mesut, Fajkovic Harun, Shariat Shahrokh F
Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria.
Institution Organizing University Doctoral Studies IOSUD, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 540142 Târgu Mureș, Romania.
J Clin Med. 2022 Oct 19;11(20):6165. doi: 10.3390/jcm11206165.
Robot-assisted partial nephrectomy (RAPN) is used more and more in present days as a therapy option for surgical treatment of cT1 renal masses. Current guidelines equally recommend open (OPN), laparoscopic (LPN), or robotic partial nephrectomy (PN). The aim of this review was to analyze the most representative RAPN series in terms of reported oncological outcomes. (2) Methods: A systematic search of Webofscience, PUBMED, Clinicaltrials.gov was performed on 1 August 2022. Studies were considered eligible if they: included patients with renal cell carcinoma (RCC) stage T1, were prospective, used randomized clinical trials (RCT) or retrospective studies, had patients undergo RAPN with a minimum follow-up of 48 months. (3) Results: Reported positive surgical margin rates were from 0 to 10.5%. Local recurrence occurred in up to 3.6% of patients. Distant metastases were reported in up to 6.4% of patients. 5-year cancer free survival (CFS) estimates rates ranged from 86.4% to 98.4%. 5-year cancer specific survival (CSS) estimates rates ranged from 90.1% to 100%, and 5-year overall survival (OS) estimates rated ranged from 82.6% to 97.9%. (4) Conclusions: Data coming from retrospective and prospective series shows very good oncologic outcomes after RAPN. Up to now, 10-year survival outcomes were not reported. Taken together, RAPN deliver similar oncologic performance to OPN and LPN.
机器人辅助部分肾切除术（RAPN）如今越来越多地被用作cT1期肾肿块手术治疗的一种治疗选择。当前指南同样推荐开放性（OPN）、腹腔镜（LPN）或机器人辅助部分肾切除术（PN）。本综述的目的是根据报告的肿瘤学结果分析最具代表性的RAPN系列。（2）方法：于2022年8月1日对Webofscience、PUBMED、Clinicaltrials.gov进行了系统检索。如果研究符合以下条件则被认为合格：纳入T1期肾细胞癌（RCC）患者，为前瞻性研究，采用随机临床试验（RCT）或回顾性研究，患者接受RAPN且随访至少48个月。（3）结果：报告的阳性手术切缘率为0%至10.5%。高达3.6%的患者发生局部复发。高达6.4%的患者报告有远处转移。5年无癌生存率（CFS）估计率在86.4%至98.4%之间。5年癌症特异性生存率（CSS）估计率在90.1%至100%之间，5年总生存率（OS）估计率在82.6%至97.9%之间。（4）结论：来自回顾性和前瞻性系列的数据显示，RAPN术后的肿瘤学结果非常好。到目前为止，尚未报告10年生存结果。综上所述，RAPN的肿瘤学表现与OPN和LPN相似。
