Category: Clinical Oncology: Outcomes & Complications

MP18-4 - Single-institutional analysis of oncological outcomes of Robotic Partial Nephrectomy with a minimum follow-up of 5 years

Sat, Sep 22
10:00 AM - 12:00 PM

Introduction & Objective :

To report oncological outcomes of Robot-Assisted Partial Nephrectomy (RAPN) from a single-institution, in patients with minimum 5-years follow-up.


Methods :

Consecutive patients undergoing RAPN for renal cell carcinoma (RCC) since October 2006 were extracted from institutional prospectively-maintained PN database. Patients with < 5 years follow-up were excluded.


Demographic, perioperative, postoperative and oncological data were evaluated. Univariate competing risk regression analyses were performed to evaluate the hazard ratio (HR) on the cancer-related events for the variables of interest.


Results :

278 RAPNs for RCC were performed. Twenty-eight (10.1%) deaths occurred in the analyzed cohort during the follow-up period: 5 (1.8%) were related to metastatic-RCC. 5-year and 7-year cumulative incidence of RCC death was 1.80%. 5 and 7-year cumulative incidence of local recurrence was 3.61% and 4.16%, respectively. 5 and 7-year cumulative incidence of metastasis was 3.24% and 4.57%, respectively.


Univariate competing risk regression analysis for RCC death showed higher Fuhrman grade, larger tumor size and tumor necrosis as independent predictors (HR: 8.76, 1.67, 16.73, p-values 0.051, The retrospective design and the potential selection bias with patient selection in the early RAPN experience may limit the generalizability of the findings.


Conclusions :

This is the first study reporting minimum oncological follow-up of 5 years after RAPN. Excellent long-term oncologic outcomes after RAPN in a selected cohort of patients are hereby confirmed.

Riccardo Bertolo

MD
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
Turin, Piemonte, Italy

Riccardo Bertolo, MD
Research Fellow, Robotic Urology,
Cleveland Clinic, Cleveland, OH, USA
PhD Candidate, Bioengineering in Medical/Surgical Sciences
Turin Politechnic, Italy

Juan Garisto

MD
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
Cleveland, Ohio

Juan Garisto, MD is an Advanced Laparoscopy & Robotics clinical fellow at Cleveland Clinic, Cleveland, OH, United States under the mentorship of Dr. Jihad Kaouk. He completed a Society of Urologic Oncology fellowship at the University of Toronto and did his urology residency training at Complejo Hospitalario Dr. A.A.Madrid in Panama City, Panama.

His current research interest in single port surgery and multidisciplinary management of urologic malignancies, in particular kidney and bladder cancer.

Julien Dagenais

MD
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
Cleveland, Ohio

Daniel Sagalovich

MD
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
Cleveland, Ohio

Robert Stein

MD
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
Cleveland, Ohio

Khaled Fareed

Assistant Professor
Cleveland Clinic
Cleveland, Ohio

Khaled Fareed, MD
Assistant Professor of Urology, Lerner College of Medicine at Case Western Reserve University and Staff Urologist at Glickman Urological & Kidney Institiue at Cleveland Clinic
Graduated from Assiut University Medical School, Egypt in 1994, completed 2 years residency training in Assiut University Hospital. finished 2 years Research fellowship at the University of Texas, Southwestern Medical Center, and Residency training in urology at the same center. joined Cleveland Clinic in 2007 and been on staff. interests in EndoUrology, Advanced laparoscopy, image-guided Therapy, Robotics and BPH, Mens voiding dysfunction.

Tianming Gao

PhD
Quantitiative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
Cleveland, Ohio

Amr Fergany

MD
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
Cleveland, Ohio

Jihad Kaouk

Professor and Director, Center for Robotic and Image Guided Surgery Vice Chair, Surgical Innovations
Glickman Urologic Institute, Cleveland Clinic
Cleveland, Ohio

Jihad Kaouk, MD FACS

Dr. Jihad Kaouk is an American Board certified Urologist and Director, Center of Robotic and Image Guided Surgery at the Cleveland Clinic Glickman Urological Institute. He also serves as Professor of Surgery at the Cleveland Clinic Lerner College of Medicine, Vice Chair for Surgical Innovations and chair holder for the Zegarac-Pollock Endowed Chair in laparoscopic and robotic surgery.
In Innovations, he has performed several first ever done surgical procedures, including the first Robotic single port surgery through the belly button in 2008, the first completely transvaginal kidney removal in 2009, and the first robotic perineal prostatectomy in 2014 Dr. Kaouk holds 2 USA patents for medical devices used during partial nephrectomy and in robotic surgery.

Since 2005, Dr. Kaouk has served on committees at the national and local levels. From 2005-2008, he served in the American Urological Association’s Urologic Diagnostic and Therapeutic Imaging Task Force, from 2006-2010 he was on the Guidelines for the Management of small Renal Masses committee. Currently Dr Kaouk serves as Chairman elect on the AUA New Technology and Imaging committee, and is President Elect of (SURS) Society of Urologic Robotic Surgery. Dr Kaouk is associate editor of Urology journal.

Dr Kaouk have lectured in 130 scientific meetings, chaired 24 urologic meeting and performed live surgery in 18 medical centers worldwide. He authored 460 peer reviewed scientific publication, 26 book chapters and hundreds of scientific abstracts and surgical movies. Dr Kaouk received 32 honors and awards including Cleveland clinic innovator award twice, Teacher of the Year award, and EndoUrology 2017 Best Fellowship Program Director Award.

Presently, Dr Kaouk holds membership with the American Urological Association, the Endourological Society, Society of Urologic Oncology, Society of Robotic Surgery, and the Lebanese Order of Physicians. He is a fellow of the American college of Surgeons.