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Real-world outcomes of patients with renal cell carcinoma, surgically treated at regional hospitals, based on a prospective long-term survey of the pre-robotic era

PURPOSE: Renal cancer surgery is frequently performed in small regional hospitals in Japan. This study evaluated the outcomes of renal cancer surgery, comparing results from the pre-robotic surgery era with those obtained with robotic surgery. METHODS: This prospective cohort study was conducted on...

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Autores principales: Kawasaki, Yoshihide, Saito, Hideo, Ioritani, Naomasa, Tochigi, Tatsuo, Numata, Isamu, Numahata, Kenji, Soma, Fumihiko, Kyan, Atsushi, Ishidoya, Shigeto, Ota, Shozo, Namima, Takashige, Orikasa, Kazuhiko, Yamashita, Shinichi, Mitsuzuka, Koji, Arai, Yoichi, Ito, Akihiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10030418/
https://www.ncbi.nlm.nih.gov/pubmed/36781679
http://dx.doi.org/10.1007/s11255-023-03477-5
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author Kawasaki, Yoshihide
Saito, Hideo
Ioritani, Naomasa
Tochigi, Tatsuo
Numata, Isamu
Numahata, Kenji
Soma, Fumihiko
Kyan, Atsushi
Ishidoya, Shigeto
Ota, Shozo
Namima, Takashige
Orikasa, Kazuhiko
Yamashita, Shinichi
Mitsuzuka, Koji
Arai, Yoichi
Ito, Akihiro
author_facet Kawasaki, Yoshihide
Saito, Hideo
Ioritani, Naomasa
Tochigi, Tatsuo
Numata, Isamu
Numahata, Kenji
Soma, Fumihiko
Kyan, Atsushi
Ishidoya, Shigeto
Ota, Shozo
Namima, Takashige
Orikasa, Kazuhiko
Yamashita, Shinichi
Mitsuzuka, Koji
Arai, Yoichi
Ito, Akihiro
author_sort Kawasaki, Yoshihide
collection PubMed
description PURPOSE: Renal cancer surgery is frequently performed in small regional hospitals in Japan. This study evaluated the outcomes of renal cancer surgery, comparing results from the pre-robotic surgery era with those obtained with robotic surgery. METHODS: This prospective cohort study was conducted on patients who underwent renal cancer surgery between 2008 and 2013 at 14 hospitals, comprising 13 regional hospitals and a university hospital, registered in the Tohoku Urological Evidence-Based Medicine Study Group. The patients’ backgrounds; perioperative data; annual postoperative renal function; and prognostic surveys, performed over a median follow-up period of 10 years were obtained. RESULTS: In 930 surgical cases at the 14 registered hospitals, the 10-year recurrence-free survival rates of cT1a, cT1b, cT2, and cT3 were 0.9326, 0.8501, 0.5786, and 0.5101, respectively. Meanwhile, the 10-year overall survival rates were 0.9612, 0.8662, 0.7505, and 0.7209, respectively. Long-term observation in patients with cT1 showed that vessel involvement and high tumor grade were prognostic factors for recurrence. As a noteworthy fact, radical nephrectomy was performed in 53.3% of patients with cT1a at the regional hospitals. However, even in patients with preoperative chronic kidney disease stage 3, radical nephrectomy was not a prognostic factor of renal function. This indicates that compensatory mechanisms had been working for a long time in many patients who underwent radical nephrectomies without hypertension and preoperative proteinuria, which were predictors of end-stage renal disease. CONCLUSION: Based on a prospective long-term survey of the pre-robotic era, our results suggested no difference of the survival outcomes between the university hospital and regional hospitals. Our study provides baseline data to evaluate the outcomes of renal cancer robotic surgery, performed at regional hospitals. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11255-023-03477-5.
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spelling pubmed-100304182023-03-23 Real-world outcomes of patients with renal cell carcinoma, surgically treated at regional hospitals, based on a prospective long-term survey of the pre-robotic era Kawasaki, Yoshihide Saito, Hideo Ioritani, Naomasa Tochigi, Tatsuo Numata, Isamu Numahata, Kenji Soma, Fumihiko Kyan, Atsushi Ishidoya, Shigeto Ota, Shozo Namima, Takashige Orikasa, Kazuhiko Yamashita, Shinichi Mitsuzuka, Koji Arai, Yoichi Ito, Akihiro Int Urol Nephrol Urology - Original Paper PURPOSE: Renal cancer surgery is frequently performed in small regional hospitals in Japan. This study evaluated the outcomes of renal cancer surgery, comparing results from the pre-robotic surgery era with those obtained with robotic surgery. METHODS: This prospective cohort study was conducted on patients who underwent renal cancer surgery between 2008 and 2013 at 14 hospitals, comprising 13 regional hospitals and a university hospital, registered in the Tohoku Urological Evidence-Based Medicine Study Group. The patients’ backgrounds; perioperative data; annual postoperative renal function; and prognostic surveys, performed over a median follow-up period of 10 years were obtained. RESULTS: In 930 surgical cases at the 14 registered hospitals, the 10-year recurrence-free survival rates of cT1a, cT1b, cT2, and cT3 were 0.9326, 0.8501, 0.5786, and 0.5101, respectively. Meanwhile, the 10-year overall survival rates were 0.9612, 0.8662, 0.7505, and 0.7209, respectively. Long-term observation in patients with cT1 showed that vessel involvement and high tumor grade were prognostic factors for recurrence. As a noteworthy fact, radical nephrectomy was performed in 53.3% of patients with cT1a at the regional hospitals. However, even in patients with preoperative chronic kidney disease stage 3, radical nephrectomy was not a prognostic factor of renal function. This indicates that compensatory mechanisms had been working for a long time in many patients who underwent radical nephrectomies without hypertension and preoperative proteinuria, which were predictors of end-stage renal disease. CONCLUSION: Based on a prospective long-term survey of the pre-robotic era, our results suggested no difference of the survival outcomes between the university hospital and regional hospitals. Our study provides baseline data to evaluate the outcomes of renal cancer robotic surgery, performed at regional hospitals. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11255-023-03477-5. Springer Netherlands 2023-02-13 2023 /pmc/articles/PMC10030418/ /pubmed/36781679 http://dx.doi.org/10.1007/s11255-023-03477-5 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/ Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Urology - Original Paper
Kawasaki, Yoshihide
Saito, Hideo
Ioritani, Naomasa
Tochigi, Tatsuo
Numata, Isamu
Numahata, Kenji
Soma, Fumihiko
Kyan, Atsushi
Ishidoya, Shigeto
Ota, Shozo
Namima, Takashige
Orikasa, Kazuhiko
Yamashita, Shinichi
Mitsuzuka, Koji
Arai, Yoichi
Ito, Akihiro
Real-world outcomes of patients with renal cell carcinoma, surgically treated at regional hospitals, based on a prospective long-term survey of the pre-robotic era
title Real-world outcomes of patients with renal cell carcinoma, surgically treated at regional hospitals, based on a prospective long-term survey of the pre-robotic era
title_full Real-world outcomes of patients with renal cell carcinoma, surgically treated at regional hospitals, based on a prospective long-term survey of the pre-robotic era
title_fullStr Real-world outcomes of patients with renal cell carcinoma, surgically treated at regional hospitals, based on a prospective long-term survey of the pre-robotic era
title_full_unstemmed Real-world outcomes of patients with renal cell carcinoma, surgically treated at regional hospitals, based on a prospective long-term survey of the pre-robotic era
title_short Real-world outcomes of patients with renal cell carcinoma, surgically treated at regional hospitals, based on a prospective long-term survey of the pre-robotic era
title_sort real-world outcomes of patients with renal cell carcinoma, surgically treated at regional hospitals, based on a prospective long-term survey of the pre-robotic era
topic Urology - Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10030418/
https://www.ncbi.nlm.nih.gov/pubmed/36781679
http://dx.doi.org/10.1007/s11255-023-03477-5
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