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External Validation of a Novel Comprehensive Trifecta System in Predicting Oncologic and Functional Outcomes of Partial Nephrectomy: Results of a Multicentric Series

Background: To validate a novel trifecta for evaluating outcomes of partial nephrectomy (PN) on a multicentric dataset. Methods: Between 2007 and 2020, three renal cancer databases were queried for patients with solitary renal masses who underwent PN (n = 649). Trifecta was estimated for overall coh...

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Autores principales: Anceschi, Umberto, Flammia, Rocco Simone, Mattevi, Daniele, Tufano, Antonio, Brassetti, Aldo, Ferriero, Maria Consiglia, Tuderti, Gabriele, Misuraca, Leonardo, Bove, Alfredo Maria, Mastroianni, Riccardo, Marsiliani, Davide, Puglisi, Marco, Cai, Tommaso, Leonardo, Costantino, Gallucci, Michele, Malossini, Gianni, Luciani, Lorenzo Giuseppe, Simone, Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8837057/
https://www.ncbi.nlm.nih.gov/pubmed/35160248
http://dx.doi.org/10.3390/jcm11030796
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author Anceschi, Umberto
Flammia, Rocco Simone
Mattevi, Daniele
Tufano, Antonio
Brassetti, Aldo
Ferriero, Maria Consiglia
Tuderti, Gabriele
Misuraca, Leonardo
Bove, Alfredo Maria
Mastroianni, Riccardo
Marsiliani, Davide
Puglisi, Marco
Cai, Tommaso
Leonardo, Costantino
Gallucci, Michele
Malossini, Gianni
Luciani, Lorenzo Giuseppe
Simone, Giuseppe
author_facet Anceschi, Umberto
Flammia, Rocco Simone
Mattevi, Daniele
Tufano, Antonio
Brassetti, Aldo
Ferriero, Maria Consiglia
Tuderti, Gabriele
Misuraca, Leonardo
Bove, Alfredo Maria
Mastroianni, Riccardo
Marsiliani, Davide
Puglisi, Marco
Cai, Tommaso
Leonardo, Costantino
Gallucci, Michele
Malossini, Gianni
Luciani, Lorenzo Giuseppe
Simone, Giuseppe
author_sort Anceschi, Umberto
collection PubMed
description Background: To validate a novel trifecta for evaluating outcomes of partial nephrectomy (PN) on a multicentric dataset. Methods: Between 2007 and 2020, three renal cancer databases were queried for patients with solitary renal masses who underwent PN (n = 649). Trifecta was estimated for overall cohort and contributing centers. Overall survival (OS), cancer-specific survival (CSS) and end-stage renal disease (ESRD) probabilities were assessed by Kaplan–Meier. Cox regression was used to identify predictors of OS, CSS, ESRD. For all analyses, a p < 0.05 was considered significant. Results: At a median follow-up of 22.7 months (IQR 12.5–76.5) overall trifecta was 76.7% [Centre A; (n = 230; 68.6%), B (n = 68; 77.3%), C (n = 200; 88.4%); p = 0.001). On Kaplan–Meier, patients achieving trifecta exhibited higher OS (p = 0.024), higher CSS (p = 0.015) and lower ESRD rates (p = 0.024). On multivariable analysis, age (HR 1.04; 95% CI 1.01–1.08) and trifecta (HR 0.34; 95% CI 0.15–0.76) were independent predictors of OS while pT stage (HR 1.95; 95% CI 0.45–8.43) and trifecta (HR 0.33; 95% CI 0.16–0.67) were predictors of CSS (each p < 0.01). Preoperative CKD stage ≥ 3a (HR 13.1; 95% CI 4.07–42.6) and trifecta (HR 0.41; 95% CI 0.19–0.87) were independent predictors of ESRD (each p < 0.05). Conclusions: On external validation, trifecta was an independent predictor of all PN endpoints, regardless of hilar control and ischemia duration.
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spelling pubmed-88370572022-02-12 External Validation of a Novel Comprehensive Trifecta System in Predicting Oncologic and Functional Outcomes of Partial Nephrectomy: Results of a Multicentric Series Anceschi, Umberto Flammia, Rocco Simone Mattevi, Daniele Tufano, Antonio Brassetti, Aldo Ferriero, Maria Consiglia Tuderti, Gabriele Misuraca, Leonardo Bove, Alfredo Maria Mastroianni, Riccardo Marsiliani, Davide Puglisi, Marco Cai, Tommaso Leonardo, Costantino Gallucci, Michele Malossini, Gianni Luciani, Lorenzo Giuseppe Simone, Giuseppe J Clin Med Article Background: To validate a novel trifecta for evaluating outcomes of partial nephrectomy (PN) on a multicentric dataset. Methods: Between 2007 and 2020, three renal cancer databases were queried for patients with solitary renal masses who underwent PN (n = 649). Trifecta was estimated for overall cohort and contributing centers. Overall survival (OS), cancer-specific survival (CSS) and end-stage renal disease (ESRD) probabilities were assessed by Kaplan–Meier. Cox regression was used to identify predictors of OS, CSS, ESRD. For all analyses, a p < 0.05 was considered significant. Results: At a median follow-up of 22.7 months (IQR 12.5–76.5) overall trifecta was 76.7% [Centre A; (n = 230; 68.6%), B (n = 68; 77.3%), C (n = 200; 88.4%); p = 0.001). On Kaplan–Meier, patients achieving trifecta exhibited higher OS (p = 0.024), higher CSS (p = 0.015) and lower ESRD rates (p = 0.024). On multivariable analysis, age (HR 1.04; 95% CI 1.01–1.08) and trifecta (HR 0.34; 95% CI 0.15–0.76) were independent predictors of OS while pT stage (HR 1.95; 95% CI 0.45–8.43) and trifecta (HR 0.33; 95% CI 0.16–0.67) were predictors of CSS (each p < 0.01). Preoperative CKD stage ≥ 3a (HR 13.1; 95% CI 4.07–42.6) and trifecta (HR 0.41; 95% CI 0.19–0.87) were independent predictors of ESRD (each p < 0.05). Conclusions: On external validation, trifecta was an independent predictor of all PN endpoints, regardless of hilar control and ischemia duration. MDPI 2022-02-01 /pmc/articles/PMC8837057/ /pubmed/35160248 http://dx.doi.org/10.3390/jcm11030796 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Anceschi, Umberto
Flammia, Rocco Simone
Mattevi, Daniele
Tufano, Antonio
Brassetti, Aldo
Ferriero, Maria Consiglia
Tuderti, Gabriele
Misuraca, Leonardo
Bove, Alfredo Maria
Mastroianni, Riccardo
Marsiliani, Davide
Puglisi, Marco
Cai, Tommaso
Leonardo, Costantino
Gallucci, Michele
Malossini, Gianni
Luciani, Lorenzo Giuseppe
Simone, Giuseppe
External Validation of a Novel Comprehensive Trifecta System in Predicting Oncologic and Functional Outcomes of Partial Nephrectomy: Results of a Multicentric Series
title External Validation of a Novel Comprehensive Trifecta System in Predicting Oncologic and Functional Outcomes of Partial Nephrectomy: Results of a Multicentric Series
title_full External Validation of a Novel Comprehensive Trifecta System in Predicting Oncologic and Functional Outcomes of Partial Nephrectomy: Results of a Multicentric Series
title_fullStr External Validation of a Novel Comprehensive Trifecta System in Predicting Oncologic and Functional Outcomes of Partial Nephrectomy: Results of a Multicentric Series
title_full_unstemmed External Validation of a Novel Comprehensive Trifecta System in Predicting Oncologic and Functional Outcomes of Partial Nephrectomy: Results of a Multicentric Series
title_short External Validation of a Novel Comprehensive Trifecta System in Predicting Oncologic and Functional Outcomes of Partial Nephrectomy: Results of a Multicentric Series
title_sort external validation of a novel comprehensive trifecta system in predicting oncologic and functional outcomes of partial nephrectomy: results of a multicentric series
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8837057/
https://www.ncbi.nlm.nih.gov/pubmed/35160248
http://dx.doi.org/10.3390/jcm11030796
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