Conversion of Robot-assisted Partial Nephrectomy to Radical Nephrectomy: A Prospective Multi-institutional Study.
Document Type
Article
Publication Title
Urology
Abstract
OBJECTIVE: To assess the incidence and factors affecting conversion from robot-assisted partial nephrectomy (RAPN) to radical nephrectomy.
METHODS: Between November 2014 and February 2017, 501 patients underwent attempted RAPN by 22 surgeons at 14 centers in 9 countries within the Vattikuti Collaborative Quality Initiative database. Patients were permanently logged for RAPN prior to surgery and were analyzed on an intention-to-treat basis. Multivariable logistic regression with backward stepwise selection of variables was done to assess the factors associated with conversion to radical nephrectomy.
RESULTS: Overall conversion rate was 25 of 501 (5%). Patients converted to radical nephrectomy were older (median age [interquartile range] 66.0 [61.0-74.0] vs 59.0 [50.0-68.0], P = .012), had higher body mass index (BMI) (median 32.8 [24.9-40.9] vs 27.8 [24.6-31.5] kg/m
CONCLUSION: RAPN was associated with a low rate of conversion. Independent predictors of conversion were BMI and Charlson score. Tumor factors such as clinical stage, location, multifocality, or RENAL score were not associated with increased risk of conversion.
First Page
85
Last Page
90
DOI
10.1016/j.urology.2017.11.046
Publication Date
3-1-2018
Recommended Citation
Arora S, Chun B, Ahlawat RK, Abaza R, Adshead J, Porter JR, Challacombe B, Dasgupta P, Gandaglia G, Moon DA, Yuvaraja TB, Capitanio U, Larcher A, Porpiglia F, Mottrie A, Bhandari M, Rogers C. Conversion of Robot-assisted Partial Nephrectomy to Radical Nephrectomy: A Prospective Multi-institutional Study. Urology. 2018 Mar;113:85-90. doi: 10.1016/j.urology.2017.11.046. Epub 2017 Dec 25. PMID: 29284123.