Robotic partial nephrectomy appears to be a reasonable option for certain renal masses, provided that an experienced surgeon performs the procedure at a center that can manage postoperative complications, researchers concluded after conducting an analysis involving nearly 1,800 individuals. Participants had cT1a (n=1358), cT1b (n=379), or cT2a (n=41) renal masses. Investigators looked at how intra and postoperative outcomes in patients with cT2a masses compared to those with the other 2 mass types. Among the results:
- Performing robotic surgery on cT2a vs cT1a masses resulted in a 12% longer operative time, 32% increase in estimated blood loss, 7% increase in ischemia time, nearly 4-fold higher odds of acute kidney injury at discharge, and a nearly 11-fold higher recurrence risk.
- Performing the procedure on cT2a vs cT1b masses resulted in a 12% increase in blood loss.
- Operative time and recurrence risk were not statistically different.
- Complications, positive margins, length of stay, and renal function decline up to 2 years post-procedure were not statistically different.
Delto J, Paulucci D, Helbig M, et al. Robotic partial nephrectomy for large renal masses: A multi-institutional series. [Published online ahead of print January 22, 2018]. BJU Int. doi:10.1111/bju.14139.
This Week's Must Reads
Flat pricing of ibrutinib , Sales revenues at the potential expense of patient safety https://cancerletter.com/articles/20180413_5/
Most oncologists discuss medical marijuana with patients, Braun I et al. J Clin Oncol. 2018 May 10. doi: 10.1200/JCO.2017.76.1221.
$800M cut proposed for Centers for Medicare & Medicaid Innovation, Proposed rescission of budget authority https://www.whitehouse.gov/wp-content/uploads/2018/05/POTUS-Rescission-Transmittal-Package-5.8.2018.pdf
Medicare Beneficiary Identifiers required for billing by 2019, New Medicare cards https://www.cms.gov/medicare/new-medicare-card/nmc-home.html
Trump administration unveils drug pricing initiative, American Patients First https://www.hhs.gov/sites/default/files/AmericanPatientsFirst.pdf
Must Reads in Renal Cell Carcinoma
miRNAs are biomarkers for RCC prognosis, Pan X et al. Biomedicine and Pharmacotherapy 102: 2018; 718-27. https://doi.org/10.1016/j.biopha.2018.03.072
Pseudocapsule status predicts RCC prognosis, Xi W et al. The Journal of Urology 199: 2018; 915-20. https://doi.org/10.1016/j.juro.2017.10.043
New model uses histologic subtypes to predict RCC prognosis, Leibovich B et al. European Urology 73; 2018: 772-80. https://doi.org/10.1016/j.eururo.2018.01.005
Histologic similarities in clear cell papillary RCC and tuberous sclerosis, Williamson S et al. Human Pathology 75; 2018: 10-15 https://doi.org/10.1016/j.humpath.2017.11.013
IMDC risk group classification predicts sunitinib response, Rini B et al. Clinical Genitourinary Cancer; published online May 4, 2018 https://doi.org/10.1016/j.clgc.2018.04.005