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Longo N, Minervini A, Antonelli A, Bianchi G, Bocciardi AM, Cunico SC, Fiori C, Fusco F, Giancane S, Mari A, Martorana G, Mirone V, Morgia G, Novara G, Porpiglia F, Raspollini MR, Rocco F, Rovereto B, Schiavina R, Serni S, Simeone C, Verze P, Volpe A, Ficarra V, Carini M. Simple enucleation versus standard partial nephrectomy for clinical T1 renal masses: perioperative outcomes based on a matched-pair comparison of 396 patients (RECORd project). Eur J Surg Oncol 2014; 40:762-8. [PMID: 24529794 DOI: 10.1016/j.ejso.2014.01.007] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 12/23/2013] [Accepted: 01/09/2014] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES To compare simple enucleation (SE) and standard partial nephrectomy (SPN) in terms of surgical results in a multicenter dataset (RECORd Project). MATERIALS AND METHODS patients treated with nephron sparing surgery (NSS) for clinical T1 renal tumors between January 2009 and January 2011 were evaluated. Overall, 198 patients who underwent SE were retrospectively matched to 198 patients who underwent SPN. The SPN and SE groups were compared regarding intraoperative, early post-operative and pathologic outcome variables. Multivariable analysis was applied to analyze predictors of positive surgical margin (PSM) status. RESULTS SE was associated with similar WIT (18 vs 17.8 min), lower intraoperative blood loss (177 vs 221 cc, p = 0.02) and shorter operative time (121 vs 147 min; p < 0.0001). Surgical approach (laparoscopic vs. open), tumor size and type of indication (elective/relative vs absolute) were associated with WIT >20 min. The incidence of PSM was significantly lower in patients treated with SE (1.4% vs 6.9%; p = 0.02). At multivariable analysis, PSM was related to the surgical technique, with a 4.7-fold increased risk of PSM for SPN compared to SE. The incidence of overall, medical and surgical complications was similar between SE and SPN. CONCLUSIONS Type of NSS technique (SE vs SPN) adopted has a negligible impact on WIT and postoperative morbidity but SE seems protective against PSM occurrence.
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Affiliation(s)
- N Longo
- Policlinico Federico II, Università di Napoli, Italy
| | - A Minervini
- Clinica Urologica I, AOUC, Università di Firenze, Italy
| | - A Antonelli
- Unità Operativa di Urologia Dipartimento di NefroUrologia, Azienda AO Spedali Civili di Brescia, Italy
| | - G Bianchi
- Policlinico di Modena, Clinica Urologica, Università di Modena, Italy
| | - A M Bocciardi
- Dipartimento Chirurgico Polispecialistico, Urologia, Azienda Ospedaliera Ospedale Riguarda Ca' Granda, Milano, Italy
| | - S C Cunico
- Unità Operativa di Urologia Dipartimento di NefroUrologia, Azienda AO Spedali Civili di Brescia, Italy
| | - C Fiori
- Divisione di Urologia, Università di Torino, Ospedale San Luigi Gonzaga, Orbassano, Torino, Italy
| | - F Fusco
- Policlinico Federico II, Università di Napoli, Italy.
| | - S Giancane
- Clinica Urologica I, AOUC, Università di Firenze, Italy
| | - A Mari
- Clinica Urologica I, AOUC, Università di Firenze, Italy
| | - G Martorana
- Dipartimento di Urologia, Università di Bologna, Ospedale S. Orsola-Malpighi, Bologna, Italy
| | - V Mirone
- Policlinico Federico II, Università di Napoli, Italy
| | | | - G Novara
- Clinica Urologica, Università di Padova, Padova, Italy
| | - F Porpiglia
- Divisione di Urologia, Università di Torino, Ospedale San Luigi Gonzaga, Orbassano, Torino, Italy
| | - M R Raspollini
- Department of Pathology, University of Florence, Careggi Hospital, Florence, Italy
| | - F Rocco
- Ospedale Maggiore Policlinico Mangiagalli e Regina Elena, Università di Milano, Italy
| | - B Rovereto
- I.R.C.C.S. Policlinico San Matteo - Struttura Di Urologia, Italy
| | - R Schiavina
- Dipartimento di Urologia, Università di Bologna, Ospedale S. Orsola-Malpighi, Bologna, Italy
| | - S Serni
- Clinica Urologica I, AOUC, Università di Firenze, Italy
| | - C Simeone
- Unità Operativa di Urologia Dipartimento di NefroUrologia, Azienda AO Spedali Civili di Brescia, Italy
| | - P Verze
- Policlinico Federico II, Università di Napoli, Italy
| | - A Volpe
- Dipartimento di Urologia, Azienda Ospedaliera Maggiore della Carità, Novara, Italy
| | - V Ficarra
- Clinica Urologica, Università di Padova, Padova, Italy
| | - M Carini
- Clinica Urologica I, AOUC, Università di Firenze, Italy
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Balzarini P, Grigolato P, Tardanico R, Cadei M, Cunico SC, Cozzoli A, Zanotelli T, van den Berghe H, Dal Cin P. Multitechnical pathological diagnosis in chromophobe renal cell carcinoma. Oncol Rep 1999; 6:295-9. [PMID: 10022992 DOI: 10.3892/or.6.2.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Two new cases of chromophobe renal cell carcinoma were diagnosed on the basis of their morphology and their karyotype complemented by flow cytometry. In one of these cases, however, all these investigations were not sufficient and additional histochemistry investigation had to be used to completely rule out other renal tumors such as oncocytoma, the prognosis of which is totally different.
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Affiliation(s)
- P Balzarini
- Cattedra di Anatomia e Istologia Patologica, Spedali Civili di Brescia, 25124 Brescia, Italy
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