Surgical quality, cancer control and functional preservation: introducing a novel Trifecta for robot-assisted partial nephrectomy.

Surgical quality, cancer control and functional preservation: introducing a novel Trifecta for robot-assisted partial nephrectomy. Minerva Urol Nefrol. 2019 Dec 12;: Authors: Brassetti A, Anceschi U, Bertolo R, Ferriero M, Tuderti G, Capitanio U, Larcher A, Garisto J, Antonelli A, Mottire A, Minervini A, Dell'oglio P, Veccia A, Amparore D, Flammia RS, Mari A, Porpiglia F, Montorsi F, Kaouk J, Autorino R, Carini M, Gallucci M, Simone G Abstract BACKGROUND: To improve standard reporting of outcomes after partial nephrectomy, different "Trifecta" systems have been conceived. The subjective assessment of the included parameters and the unreliability for off-clamp procedures limited their reproducibility; their role in predicting functional and oncologic outcomes has never been assessed. We propose a new trifecta, based on standardized parameters, that summarizes PN outcomes regardless the clamping technique used and predicts main clinical outcomes. METHODS: A Retrospective analysis of a multicenter, multi-national dataset of patients with non-metastatic cT1-2 renal masses undergoing Robot-assisted partial nephrectomy was performed. Baseline demographic, clinical, pathologic and perioperative data were collected. Trifecta was defined as the coexistence of negative margins, no Clavien-Dindo ≥3 complications and ≤30% postoperative estimated glomerular filtration rate reduction. Univariable and multivariable regression analyses identified pred...
Source: Minerva Urologica e Nefrologica - Category: Urology & Nephrology Tags: Minerva Urol Nefrol Source Type: research

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Prognostic value of connective tissue growth factor and c-Myb expression in IgA nephropathy and Henoch-Schönlein purpura-A pilot immunohistochemical study. Acta Histochem. 2019 Dec 20;:151479 Authors: Mizdrak M, Filipović N, Vukojević K, Čapkun V, Mizdrak I, Durdov MG Abstract AIM: Adverse and advanced prognostic signs in IgA nephropathy (IgAN) are interstitial fibrosis and tubular atrophy, but early predictors of bad outcome are still lacking. We investigated expression of connective tissue growth factor (CTGF) and c-Myb in renal biopsies of IgAN and Henoch-Schönlein purpura (HSP), becau...
Source: Acta Histochemica - Category: Biochemistry Authors: Tags: Acta Histochem Source Type: research
Abstract AIM: To provide a comprehensive analysis of the outcomes of partial nephrectomy (PN) and radical nephrectomy (RN) for renal cell carcinoma (RCC) in older patients. METHODS: The RESURGE project is a multi-institutional dataset including 24 institutions worldwide collecting data of patients older than 75 years old who underwent RN or PN. RESULTS: Among three already published studies, RN patients were older (p 
Source: Aging Clinical and Experimental Research - Category: Geriatrics Authors: Tags: Aging Clin Exp Res Source Type: research
Publication date: Available online 28 May 2019Source: European UrologyAuthor(s): Andrea Minervini, Riccardo Campi, Andrea Mari, Alessandro Antonelli
Source: European Urology - Category: Urology & Nephrology Source Type: research
Therapeutic Targeting of Fibrotic Epithelial-Mesenchymal Transition–An Outstanding Challenge Attila Fintha1, Ákos Gasparics2, László Rosivall3 and Attila Sebe3,4* 12nd Department of Pathology, Semmelweis University, Budapest, Hungary 21st Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary 3Department of Pathophysiology, International Nephrology Research and Training Center, Semmelweis University, Budapest, Hungary 4Division of Medical Biotechnology, Paul Ehrlich Institute, Langen, Germany Back in 1995, a landmark paper was published, which shaped the fi...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Conclusions: Increasing SUA was associated with poorer outcomes. Decreased SUA levels were associated with statin intake and lower stage disease as well as lack of progression to CKD and anemia. Further investigation is requisite.
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Article Source Type: research
Authors: de Francisco ALM, Macía M, Alonso F, García P, Gutierrez E, Quintana LF, Quiroga B, Torregrosa I Abstract Chronic kidney disease (CKD), cancer and haematological diseases share areas of reciprocal influence. Cancer can affect the kidney either as glomerular lesions or as a result of the toxic effects of medication or radiation with acute (thrombotic microangiopathy, acute kidney injury, interstitial nephropathies among others) or chronic processes (worsening of CKD after nephrectomy due to renal cancer, interstitial fibrosis, hydroelectrolytic disorders). On the other hand, patients who requi...
Source: Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia - Category: Urology & Nephrology Tags: Nefrologia Source Type: research
CONCLUSIONS: The prevalence of adverse renal effects after treatment with cisplatin, carboplatin, ifosfamide, radiation therapy involving the kidney region, nephrectomy, or any combination of these, ranged from 0% to 84% depending on the study population, received treatment combination, reported outcome measure, follow-up duration and methodological quality. With currently available evidence, it was not possible to draw solid conclusions regarding the prevalence of, and treatment-related risk factors for, specific adverse renal effects. Future studies should focus on adequate study designs and reporting, including large pr...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Authors: Jabaji RB, Fischer H, Kern T, Chien GW Abstract INTRODUCTION: Rapid adoption of robotics has introduced a paradigm change in prostate cancer treatment, with more than 80% of prostatectomies performed robotically in 2015. For treatment of renal cell carcinoma (RCC), this change has not previously been reported. We evaluated trends in surgical management of RCC in Kaiser Permanente Southern California (KPSC) within the last 16 years, especially after adoption of robotics. METHODS: From January 1999 to September 2015, all KPSC members who underwent surgical treatment of suspected RCC were included retrosp...
Source: The Permanente journal - Category: General Medicine Tags: Perm J Source Type: research
Abstract PURPOSE: Partial nephrectomy (PN) is standard for small renal masses, improving renal function by preserving renal parenchyma compared with radical nephrectomy. Recent work demonstrated that postoperative surgeon assessment of volume preservation (SAVP) and 3D imaging measurements agree and correlate with postoperative function. We hypothesize preoperative assessment of volume preservation (PAVP) with PN based on preoperative imaging will reliably indicate postoperative renal function. MATERIALS AND METHODS: Data were collected from 336 patients undergoing PN for suspected renal cancer by 40 surgeons...
Source: Urologic Oncology - Category: Urology & Nephrology Authors: Tags: Urol Oncol Source Type: research
Publication date: Available online 2 November 2018Source: European UrologyAuthor(s): Julien Dagenais, Riccardo Bertolo, Juan Garisto, Matthew J. Maurice, Pascal Mouracade, Onder Kara, Jaya Chavali, Jianbo Li, Ryan Nelson, Amr Fergany, Robert Abouassaly, Jihad H. KaoukAbstractBackgroundUnderstanding physician-level discrepancies is increasingly a target of US healthcare reform for the delivery of quality-focused patient care.ObjectiveTo estimate the relative contributions of patient and surgeon characteristics to the variability in key outcomes after partial nephrectomy (PN).Design, setting, and participantsRetrospective re...
Source: European Urology - Category: Urology & Nephrology Source Type: research
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