Cargando…
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...
Autores principales: | , , , , , , , , , , , , , , , , , |
---|---|
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 |
_version_ | 1784649830921928704 |
---|---|
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. |
format | Online Article Text |
id | pubmed-8837057 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT anceschiumberto externalvalidationofanovelcomprehensivetrifectasysteminpredictingoncologicandfunctionaloutcomesofpartialnephrectomyresultsofamulticentricseries AT flammiaroccosimone externalvalidationofanovelcomprehensivetrifectasysteminpredictingoncologicandfunctionaloutcomesofpartialnephrectomyresultsofamulticentricseries AT mattevidaniele externalvalidationofanovelcomprehensivetrifectasysteminpredictingoncologicandfunctionaloutcomesofpartialnephrectomyresultsofamulticentricseries AT tufanoantonio externalvalidationofanovelcomprehensivetrifectasysteminpredictingoncologicandfunctionaloutcomesofpartialnephrectomyresultsofamulticentricseries AT brassettialdo externalvalidationofanovelcomprehensivetrifectasysteminpredictingoncologicandfunctionaloutcomesofpartialnephrectomyresultsofamulticentricseries AT ferrieromariaconsiglia externalvalidationofanovelcomprehensivetrifectasysteminpredictingoncologicandfunctionaloutcomesofpartialnephrectomyresultsofamulticentricseries AT tudertigabriele externalvalidationofanovelcomprehensivetrifectasysteminpredictingoncologicandfunctionaloutcomesofpartialnephrectomyresultsofamulticentricseries AT misuracaleonardo externalvalidationofanovelcomprehensivetrifectasysteminpredictingoncologicandfunctionaloutcomesofpartialnephrectomyresultsofamulticentricseries AT bovealfredomaria externalvalidationofanovelcomprehensivetrifectasysteminpredictingoncologicandfunctionaloutcomesofpartialnephrectomyresultsofamulticentricseries AT mastroianniriccardo externalvalidationofanovelcomprehensivetrifectasysteminpredictingoncologicandfunctionaloutcomesofpartialnephrectomyresultsofamulticentricseries AT marsilianidavide externalvalidationofanovelcomprehensivetrifectasysteminpredictingoncologicandfunctionaloutcomesofpartialnephrectomyresultsofamulticentricseries AT puglisimarco externalvalidationofanovelcomprehensivetrifectasysteminpredictingoncologicandfunctionaloutcomesofpartialnephrectomyresultsofamulticentricseries AT caitommaso externalvalidationofanovelcomprehensivetrifectasysteminpredictingoncologicandfunctionaloutcomesofpartialnephrectomyresultsofamulticentricseries AT leonardocostantino externalvalidationofanovelcomprehensivetrifectasysteminpredictingoncologicandfunctionaloutcomesofpartialnephrectomyresultsofamulticentricseries AT galluccimichele externalvalidationofanovelcomprehensivetrifectasysteminpredictingoncologicandfunctionaloutcomesofpartialnephrectomyresultsofamulticentricseries AT malossinigianni externalvalidationofanovelcomprehensivetrifectasysteminpredictingoncologicandfunctionaloutcomesofpartialnephrectomyresultsofamulticentricseries AT lucianilorenzogiuseppe externalvalidationofanovelcomprehensivetrifectasysteminpredictingoncologicandfunctionaloutcomesofpartialnephrectomyresultsofamulticentricseries AT simonegiuseppe externalvalidationofanovelcomprehensivetrifectasysteminpredictingoncologicandfunctionaloutcomesofpartialnephrectomyresultsofamulticentricseries |