Laparoscopic Partial Nephrectomy for cT1 Tumors

Evaluation Trifecta and Pentafecta Outcomes of Patients Underwent Laparoscopic Partial Nephrectomy for cT1 Renal Tumor

The aim of the study is to evaluate trifecta and pentafecta outcomes for laparoscopic partial nephrectomy (LNP) in patients with clinical T1N0M0 renal tumor.

From November 2009 to August 2018 a total of 292 patients who underwent LPN by global ischemia were included in the study. The patients were allocated into two groups according to the tumor size; T1a (≤ 40 mm, n=215), T1b (41-70 mm, n=77). Demographics features, clinical tumor characteristics, intraoperative and postoperative outcomes were analyzed. A negative surgical margin, warm ischemia time (WIT) < 20 min and no postoperative complications (Clavien-Dindo ≥ grade 3) were accepted to achieve the trifecta outcomes. Pentafecta has defined as trifecta criteria plus >90% preservation of estimated glomerular filtration rate (eGFR) and no stage upgrade of chronic kidney disease 12 months after LPN. Univariable and multivariable analysis were used to identify factors predicting trifecta and pentafecta achievement.

Inclusion Criteria:

• Functioning contraleteral kidney
• Patients with complete data
• Patients with single renal tumor on the effected side
• Patients who approved the written consent form

Exclusion Criteria:

• The patients with bilateral renal tumors (n=8, 16 LPNs)
• solitary kidney (n=8)
• horseshoe kidney (n=4)
• pelvic ectopic kidney (n=2)
• graft kidney (n=2)
• those with multiple renal tumors in a single kidney (n=3) or with > 7 cm renal tumor (n=6)
• Patients who were operated on for colon cancer (n=4), prostate cancer (n=2), endometrial cancer (n=1) or adrenal mass (n=2) within the first year after LPN