Perioperative and Mid-Term Oncological and Functional Outcomes After Partial Nephrectomy for Entirely Endophytic Renal Tumors: A Prospective Multicenter Observational Study (The RECORD2 Project)
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background and Objectives: Totally endophytic renal tumors are a unique subset that pose significant technical challenges during partial nephrectomy (PN). The aim of this study was to evaluate the perioperative, oncologic, and functional outcomes of PN in this particular setting. Materials and Methods: We retrospectively evaluated 4151 patients who had surgical treatment for renal tumors between January 2013 and December 2016 at 26 urological Italian Centers (RECORD 2 project). Only patients treated with PN for entirely endophytic renal tumor were considered for final analyses. Results: A total of 211 patients were included, with a median PADUA score of 10 (IQR 9-11). Open, laparoscopic, and robotic approaches were used in 94 (44.5%), 52 (24.6%), and 65 (30.8%) cases, respectively. While surgical approach did not impact complication rates, robotic PN had significantly lower median blood loss (100 vs. 185 vs. 175 cc, p = 0.04) and shorter operative time (126 vs. 140 vs. 160 min, p = 0.01) compared to open and laparoscopic PN. At a median follow-up of 36.3 months (IQR 21.9–49.2), recurrence-free survival was 93.8%. Median %eGFR drop at 24 months was 12.1 (IQR 5.1–21.9), with significant eGFR loss (≥25%) in 36 (17.1%) patients. The robotic approach was associated with a lower %eGFR drop at 1-month and 1-year evaluations, but the benefit diminished at 24 months. Multivariate analysis showed age and open surgery as independent predictors of renal function loss at 1 month and Trifecta failure. Conclusions: The conservative management of entirely endophytic renal tumors is associated with favorable functional and oncologic outcomes. Whenever technically feasible, conservative surgery should be prioritized to optimize early renal function recovery.
Source: Cancers
Authors: Fabrizio Di Maida, Andrea Mari, Daniele Amparore, Alessandro Antonelli, Riccardo Schiavina, Riccardo Giuseppe Bertolo, Alessandro Veccia, Eugenio Brunocilla, Riccardo Campi, Luigi Da Pozzo, Cristian Fiori, Paolo Gontero, Antonio Andrea Grosso, Luca Lambertini, Nicola Longo, Ciro Imbimbo, Alberto Briganti, Francesco Montorsi, Francesco Porpiglia, Luigi Schips, Nazareno Suardi, Sergio Serni, Bernardo Rocco, Andrea Minervini
Institutions: Azienda Ospedaliero-Universitaria Careggi, University of Florence, Ospedale San Luigi Gonzaga, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, University of Bologna, Ospedale Papa Giovanni XXIII, University of Turin, Federico II University Hospital, University of Naples Federico II, IRCCS Ospedale San Raffaele, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele, Ospedale SS. Annunziata, University of Brescia, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,499
OpenAlex ID: W4409210335