Outcomes of minimally invasive partial nephrectomy among very elderly patients: Report from the resurge collaborative international database

Alessandro Larcher, Christopher J.D. Wallis, Nicola Pavan, Francesco Porpiglia, Toshio Takagi, Kazunari Tanabe, Koon H. Rha, Ali Abdel Raheem, Bo Yang, Chao Zang, Sisto Perdonà, Giuseppe Quarto, Tobias Maurer, Thomas Amiel, Luigi Schips, Roberto Castellucci, Simone Crivellaro, Ryan Dobbs, Gianfranco Baiamonte, Antonio CeliaBernardino De Concilio, Maria Furlan, Estevão Lima, Estefania Linares, Salvatore Micali, Daniele Amparore, Geert De Naeyer, Carlo Trombetta, Lance J. Hampton, Andrew Tracey, Ahmet Bindayi, Alessandro Antonelli, Ithaar Derweesh, Carme Mir, Francesco Montorsi, Alexandre Mottrie, Riccardo Autorino, Umberto Capitanio

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2 Citations (Scopus)


The aim of the study was to perform a comprehensive investigation of clinical outcomes of robot-assisted partial nephrectomy (RAPN) or laparoscopic partial nephrectomy (LPN) in elderly patients presenting with a renal mass. The REnal SURGery in Elderly (RESURGE) collaborative database was queried to identify patients aged 75 or older diagnosed with cT1-2 renal mass and treated with RAPN or LPN. Study outcomes were: overall complications (OC); warm ischemia time (WIT) and 6-month estimated glomerular filtration rate (eGFR); positive surgical margins (PSM), disease recurrence (REC), cancer-specific mortality (CSM) and other-cause mortality (OCM). Descriptive statistics, Kaplan-Meier, smoothed Poisson plots and logistic and linear regression models (MVA) were used. Overall, 216 patients were included in this analysis. OC rate was 34%, most of them being of low Clavien grade. Median WIT was 17 minutes and median 6-month eGFR was 54 ml/min/1.73 m2. PSM rate was 5%. After a median follow-up of 20 months, the 5-year rates of REC, CSM and OCM were 4, 4 and 5%, respectively. At MVA predicting perioperative morbidity, RAPN relative to LPN (odds ratio [OR] 0.33; p <0.0001) was associated with lower OC rate. At MVA predicting functional outcomes, RAPN relative to LPN was associated with shorter WIT (estimate [EST]-4.09; p <0.0001), and with higher 6-month eGFR (EST 6.03; p = 0.01). In appropriately selected patients with small renal masses, minimally-invasive PN is associated with acceptable perioperative outcomes. The use of a robotic approach over a standard laparoscopic approach can be advantageous with respect to clinically relevant outcomes, and it should be preferred when available.

Original languageEnglish
Pages (from-to)273-279
Number of pages7
JournalCentral European Journal of Urology
Issue number3
Publication statusPublished - 2020

Bibliographical note

Publisher Copyright:
© 2020, Polish Urological Association. All rights reserved.

All Science Journal Classification (ASJC) codes

  • Urology


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