Black race may be associated with worse overall survival in renal cell carcinoma patients.

Objective: To examine socio-demographic and treatment variables in an attempt to identify factors associated with survival differences between black and white patients with renal cell carcinoma (RCC).

Patients And Methods: We identified 79,618 white and 10,604 black patients diagnosed with RCC in the National Cancer Database. We compared the distribution of socio-demographic, presentation and treatment variables between Blacks and Whites and then utilized a multivariable cox proportion hazards regression model to evaluate the contribution of differences in these variables to disparities in overall survival (OS).

A Multi-Institutional Analysis of the Effect of Positive Surgical Margins Following Robot-Assisted Partial Nephrectomy on Oncologic Outcomes.

To determine the effect of positive surgical margins (PSMs) on oncologic outcomes following robot-assisted partial nephrectomy (RAPN) and to identify factors that increase the likelihood of adverse oncologic outcomes. A multi-institutional database of patients who underwent RAPN with complete follow-up data was used to compare recurrence-free survival (RFS) and overall survival (OS) between 42 (5.1%) patients with a PSM and 797 (94.

Weighted Gleason Grade Group (WGGG): A new prostate cancer biopsy reporting system with prognostic potential.

Introduction: Presently, prostate biopsy (PBx) results report the highest Gleason Grade Group (GGG) as a single metric that gauges the overall clinical aggressiveness of cancer and dictates treatment. We hypothesized a PBx showing multiple cores of cancer with more volume cancer per core would represent more aggressive disease. We propose the Weighted Gleason Grade Group (WGGG), a novel scoring system that synthesizes all histopathologic data and cancer volume into a single numeric value representing the entire PBx, allowing for improved prediction of adverse pathology and risk of biochemical recurrence (BCR) following radical prostatectomy (RP).

A multi-institutional analysis of 263 hilar tumors during robot-assisted partial nephrectomy.

Hilar tumors pose unique challenges during partial nephrectomy. We present the characteristics and outcomes of 263 patients with hilar tumors undergoing robot-assisted partial nephrectomy (RPN) in the largest series to date. Perioperative, pathologic, functional, and oncological outcomes were compared between 1467 (84.

A Single Overnight Stay After Robotic Partial Nephrectomy Does Not Increase Complications.

To evaluate the feasibility of postoperative day 1 (POD1) discharge after robotic partial nephrectomy (RPN) and to determine whether a protocol targeting a shorter length of stay (LOS) is associated with any difference in the rate of postoperative complications. We reviewed a prospectively maintained, multi-institutional database of patients who underwent RPN from September 2013 to September 2016. Three of the six participating surgeons used a protocol that targeted discharge on POD1, whereas three surgeons did not.

Clinicopathological and survival analysis of clinically advanced papillary and chromophobe renal cell carcinoma.

Introduction: Clinically, the papillary (pRCC) and chromophobe (chRCC) histologic subtypes of renal cell carcinoma (RCC) are viewed as more indolent compared to the more-common clear cell histology (ccRCC). However, there remain advanced cases of these purportedly less-aggressive histologies that lead to significant mortality. We therefore sought to evaluate outcomes of advanced pRCC and chRCC compared to ccRCC utilizing the National Cancer Database's registry of RCC patients.

Trends and outcomes in contemporary management renal cell carcinoma and vena cava thrombus.

Introduction: We sought to analyze the safety, efficacy, and national trends in the use of robotic radical nephrectomy (RN) and inferior vena cava thrombectomy in patients with renal cell carcinoma.

Patients And Methods: We analyzed 872 patients from the National Cancer Database dataset who underwent open (n = 838, 96.1%) or robotic (n = 34, 3.

Management of high complexity renal masses in partial nephrectomy: A multicenter analysis.

Objective: To determine the safety and efficacy of performing partial nephrectomy (PN) on patients with high nephrometry score tumors.

Patients And Methods: We used a prospectively maintained multi-institutional kidney cancer database to identify 144 patients with R.E.

Predicting acute kidney injury after robot-assisted partial nephrectomy: Implications for patient selection and postoperative management.

Background: Acute Kidney Injury (AKI) is a common occurrence after partial nephrectomy and is a significant risk factor for chronic kidney disease. We aimed to create a model that predicts postoperative AKI in patients undergoing robot-assisted partial nephrectomy (RAPN).

Methods: We identified 1,190 patients who underwent RAPN between 2008 and 2017 from a multicenter database.

The Impact of Obesity in Patients Undergoing Robotic Partial Nephrectomy.

As the prevalence of obesity increases worldwide, an increasing proportion of surgical candidates have an elevated body mass index (BMI), with associated metabolic syndrome. Yet there exists limited evidence regarding the effect of elevated BMI on surgical outcomes in robotic surgeries. We examined whether obese patients had worse perioperative outcomes and postoperative renal function after robotic partial nephrectomies (RPNs).

Clinicopathologic and Genomic Factors Associated With Oncologic Outcome in Patients With Stage III to IV Chromophobe Renal Cell Carcinoma.

Background: Chromophobe renal cell carcinoma (chRCC) is known as an indolent tumor; however, mortality still occurs. We sought to determine the clinicopathologic and genomic factors associated with aggressive chRCC.

Patients And Methods: Two different datasets were used to identify patients with clinical stage III and IV chRCC.

A Comparison of Excisional Volume Loss Calculation Methods to Predict Functional Outcome After Partial Nephrectomy.

Introduction: Functional volume loss (FVL) is a significant predictor of kidney function decline after partial nephrectomy (PN). Here, we sought to assess two different methods for quantifying FVL post-PN: imaging-based tissue segmentation (TS) vs pathological analysis.

Methods And Results: From a single surgeon series, we performed a retrospective analysis of 42 patients who underwent PN for a cT1 renal mass between 2015 and 2017.

A multi-institutional report of peri-operative and functional outcomes after robot-assisted partial nephrectomy in patients with a solitary kidney.

To evaluate peri- and post-operative outcomes after robotic partial nephrectomy (RPN) in patients with a solitary kidney. A multi-institutional database of 1868 patients was used to identify 35 patients with a solitary kidney who underwent RPN at six different centers from 2007 to 2016. Peri-operative outcomes were summarized with descriptive statistics.

Hypertension and diabetes mellitus are not associated with worse renal functional outcome after partial nephrectomy in patients with normal baseline kidney function.

Objective: To analyze the association of hypertension and/or diabetes mellitus on renal function after partial nephrectomy in patients with normal baseline kidney function.

Methods: We identified 453 patients with baseline estimated glomerular filtration rate ≥60 that underwent robotic partial nephrectomy for a cT1 renal mass from 2008 to 2014 using a multi-institutional database. The association between estimated glomerular filtration rate and time (pre-partial nephrectomy to 24 months post-partial nephrectomy) was compared between 269 (59.

Risk factors and prognostic implications for pathologic upstaging to T3a after partial nephrectomy.

Background: Performing partial nephrectomy (PN) on a cT1 tumor, which postoperatively is upgraded to pT3a can possibly lead to compromise of cancer specific mortality. We therefore aimed to identify risk factors for pathologic T3a upstaging of cT1 tumors and to analyze the association between upstaging, positive surgical margins (PSM) and overall survival (OS).

Methods: The present study included patients who underwent PN for a clinically localized T1 renal mass from two datasets: 1) 1298 patients from a prospectively maintained multi-center database (MCDB); and 2) 7940 patients from the National Cancer Database (NCDB).

A Multi-Institutional Propensity Score Matched Comparison of Transperitoneal and Retroperitoneal Partial Nephrectomy for cT1 Posterior Tumors.

Objective: To compare the perioperative and renal functional outcome between transperitoneal and retroperitoneal robotic partial nephrectomy (TP-RPN and RP-RPN) in the largest cohort to date of RP-RPN for posterior tumors.

Methods: We identified 519 patients who met eligibility criteria and underwent TP-RPN (n = 357, 68.8%) or RP-RPN (n = 162, 31.

Reevaluating Warm Ischemia Time as a Predictor of Renal Function Outcomes After Robotic Partial Nephrectomy.

Objective: To explore whether variation of warm ischemia time (WIT) is associated with functional and perioperative outcomes following robotic partial nephrectomy (RPN).

Materials And Methods: Six hundred sixty eight patients, each with 2 kidneys, undergoing RPNs for a cT1 tumor were identified from a U.S.

An evaluation of race, ethnicity, age, and sex-based representation in phase I to II renal cell carcinoma clinical trials in the United States.

Introduction: Enrollment of a representative study population permits generalizable and reliable results for clinical trials. We sought to evaluate whether patients enrolled in trials for advanced renal cell carcinoma (RCC) are representative of the overall population of advanced RCC patients in the United States.

Materials And Methods: The clinicaltrials.

Lymph node yield during radical prostatectomy does not impact rate of biochemical recurrence in patients with seminal vesicle invasion and node-negative disease.

Objectives: Seminal vesicle invasion (SVI) is a risk factor for poor oncologic outcome in patients with prostate cancer. Modifications to the pelvic lymph node dissection (PLND) during radical prostatectomy (RP) have been reported to have a therapeutic benefit. The present study is the first to determine if lymph node yield (LNY) is associated with a lower risk of biochemical recurrence (BCR) for men with SVI.

Demographic and socioeconomic predictors of treatment delays, pathologic stage, and survival among patients with penile cancer: A report from the National Cancer Database.

Objectives: To evaluate whether socioeconomic factors affect pathologic stage, treatment delays, pathologic upstaging, and overall survival (OS) in patients with penile cancer (PC).

Patients And Methods: A total of 13,283 eligible patients diagnosed with PC from 1998 to 2012 were identified from the National Cancer Database. Socioeconomic, demographic and pathologic variables were used in multivariable regression models to identify predictors of pathologic T stage ≥2, pathologic lymph node positivity, cT to pT upstaging, treatment delays, and OS.

Is Off Clamp Always Beneficial During Robotic Partial Nephrectomy? A Propensity Score-Matched Comparison of Clamp Technique in Patients with Two Kidneys.

Objective: The majority of patients undergoing partial nephrectomy (PN) present with a clinical T1a tumor with both kidneys present. Some groups have advocated using off-clamp (Off-C) techniques to eliminate warm ischemia whenever possible, even when elective. We evaluated whether Off-C technique during robotic PN (RPN) provides any functional benefit over main arterial clamping (MAC) in these patients.

Differences in Renal Tumor Size Measurements for Computed Tomography Versus Magnetic Resonance Imaging: Implications for Patients on Active Surveillance.

Purpose: To evaluate and compare the accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) in predicting the final pathologic tumor size of partial nephrectomy specimens.

Materials And Methods: We analyzed a multi-institutional database of 807 patients who underwent robotic partial nephrectomy for a cT1a renal mass from 2006 to 2016. Patients who had a solitary tumor with complete data on the baseline imaging modality and the tumor size (baseline and pathologic) (n = 349) were included for analysis.

Comparison of perioperative and functional outcomes of robotic partial nephrectomy for cT1a vs cT1b renal masses.

Objective: To compare perioperative and functional outcomes of patients with cT1a or cT1b renal masses undergoing robotic partial nephrectomy (RPN) in a large multi-institutional study PATIENTS AND METHODS: The present retrospective Institutional Review Board-approved multi-institutional study utilised a prospectively maintained database to identify patients undergoing RPN by six surgeons for a solitary cT1a (n = 1 307) or cT1b (n = 377) renal mass from 2006 to 2016. Perioperative and renal function outcomes at discharge and at a median follow-up of 12.2 months were compared in univariable and multivariable regression analyses adjusting for surgeon performing the procedure and date of surgery.

Heterogeneity in renal cell carcinoma.

Introduction: In recent years, molecular characterization of renal cell carcinoma has facilitated the identification of driver genes, specific molecular pathways, and characterization of the tumor microenvironment, which has led to a better understanding of the disease. This comprehension has revolutionized the treatment for patients with metastatic disease, but despite these advancements many patients will develop resistance leading to treatment failure. A primary cause of this resistance and subsequent treatment failure is tumor heterogeneity.

Predicting Complications Following Robot-Assisted Partial Nephrectomy with the ACS NSQIP Universal Surgical Risk Calculator.

Purpose: We evaluated the predictive value of the ACS NSQIP® (American College of Surgeons National Surgical Quality Improvement Program®) surgical risk calculator in a tertiary referral cohort of patients who underwent robot-assisted partial nephrectomy.

Materials And Methods: We queried our prospectively maintained, multi-institutional database of patients treated with robot-assisted partial nephrectomy and input the preoperative details of 300 randomly selected patients into the calculator. Accuracy of the calculator was assessed by the ROC AUC and the Brier score.