Minimally Invasive Surgical Treatments in Kidney Cancer: Clinical Implications, Risk Assessment, and Outcomes

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 20 May 2024 | Viewed by 2142

Special Issue Editors


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Guest Editor
Oncologic Minimally Invasive Urology and Andrology Unit, Department of Experimental and Clinical Medicine, Careggi Hospital, University of Florence, 50121 Florence, Italy
Interests: urothelial clinical biomarkers; prognostication; endoscopic surgery; robotics
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Guest Editor
Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, 10043 Turin, Italy
Interests: urology; surgery

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Guest Editor
Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
Interests: urologic minimally-invasive surgery (mostly robot-assisted); treatment of prostate; kidney and urothelial cancers

Special Issue Information

Dear Colleagues,

This Special Issue is dedicated to exploring the advancements and implications of minimally invasive surgical treatments in kidney cancer. With the advent of robotic technology and the pursuit of improved patient outcomes, minimally invasive techniques have increasingly become the cornerstone of management in various medical disciplines, including uro-oncology. As kidney cancer remains a significant concern globally, it is imperative to understand the clinical implications of these interventions, accurately assess the associated risks, and evaluate the resultant outcomes. Through a compilation of robust original studies and reviews, this issue aims to bridge the gap in our understanding, shedding light on both the advantages and potential challenges posed by minimally invasive approaches in treating kidney cancer.

Dr. Andrea Mari
Dr. Daniele Amparore
Dr. Riccardo Bertolo
Guest Editors

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Keywords

  • minimally invasive surgery
  • robotics
  • kidney cancer
  • clinical implications
  • risk assessment
  • patient outcomes
  • uro-oncology

Published Papers (2 papers)

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16 pages, 2757 KiB  
Systematic Review
Clinical and Oncological Outcomes Following Percutaneous Cryoablation vs. Partial Nephrectomy for Clinical T1 Renal Tumours: Systematic Review and Meta-Analysis
by Łukasz Nowak, Dawid Janczak, Jan Łaszkiewicz, Maciej Guziński, Francesco Del Giudice, Anas Tresh, Benjamin I. Chung, Joanna Chorbińska, Wojciech Tomczak, Bartosz Małkiewicz, Tomasz Szydełko and Wojciech Krajewski
Cancers 2024, 16(6), 1175; https://doi.org/10.3390/cancers16061175 - 17 Mar 2024
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Abstract
Percutaneous cryoablation (PCA) can be an alternative to partial nephrectomy (PN) in selected patients with stage T1 renal tumours. Existing meta-analyses regarding ablative techniques compared both laparoscopic and PCA with PN. That is why we decided to perform a meta-analysis that focused solely [...] Read more.
Percutaneous cryoablation (PCA) can be an alternative to partial nephrectomy (PN) in selected patients with stage T1 renal tumours. Existing meta-analyses regarding ablative techniques compared both laparoscopic and PCA with PN. That is why we decided to perform a meta-analysis that focused solely on PCA. The aim of this study was to compare the complications and functional and oncological outcomes between PCA and PN. A systematic literature search was performed in January 2024. Data for dichotomous and continuous variables were expressed as pooled odds ratios (ORs) and mean differences (MDs), both with 95% confidence intervals (CIs). Effect measures for the local recurrence-free survival (LRFS), metastasis-free survival (MFS), cancer-specific survival (CSS) and overall survival (OS) were expressed as pooled hazard ratios with 95% CIs. Among 6487 patients included in the 14 selected papers, 1554 (23.9%) and 4924 (76.1%) underwent PCA and PN, respectively. Compared with the PN group, patients undergoing PCA had significantly lower overall and major postoperative complication rates. There was no difference in renal function between PCA and PN groups. When analysing collective data for cT1 renal carcinoma, PCA was associated with worse LRFS compared with PN. However, subgroup analysis revealed that in the case of PCA, LRFS was not decreased in patients with cT1a tumours. Moreover, patients undergoing robotic-assisted PN had improved LRFS compared with those undergoing PCA. No significant differences were observed between PCA and PN in terms of MFS and CSS. Finally, PCA was associated with worse OS than PN in both collective and subgroup analyses. In conclusion, PCA is associated with favourable postoperative complication rates relative to PN. Regarding LRFS, PCA is not worse than PN in cT1a tumours but has a substantially relevant disadvantage in cT1b tumours. Also, RAPN might be the only surgical modality that provides better LRFS than PCA. In cT1 tumours, PCA shows MFS and CSS comparable to PN. Lastly, PCA is associated with a shorter OS than PN. Full article
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15 pages, 761 KiB  
Systematic Review
Outcomes and Techniques of Robotic-Assisted Partial Nephrectomy (RAPN) for Renal Hilar Masses: A Comprehensive Systematic Review
by Savio Domenico Pandolfo, Zhenjie Wu, Riccardo Campi, Riccardo Bertolo, Daniele Amparore, Andrea Mari, Paolo Verze, Celeste Manfredi, Antonio Franco, Francesco Ditonno, Clara Cerrato, Matteo Ferro, Francesco Lasorsa, Roberto Contieri, Luigi Napolitano, Antonio Tufano, Giuseppe Lucarelli, Simone Cilio, Sisto Perdonà, Salvatore Siracusano, Riccardo Autorino and Achille Avetaadd Show full author list remove Hide full author list
Cancers 2024, 16(4), 693; https://doi.org/10.3390/cancers16040693 - 06 Feb 2024
Cited by 1 | Viewed by 776
Abstract
Background: Robot-assisted partial nephrectomy (RAPN) is increasingly being employed in the management of renal cell carcinoma (RCC) and it is expanding in the field of complex renal tumors. The aim of this systematic review was to consolidate and assess the results of [...] Read more.
Background: Robot-assisted partial nephrectomy (RAPN) is increasingly being employed in the management of renal cell carcinoma (RCC) and it is expanding in the field of complex renal tumors. The aim of this systematic review was to consolidate and assess the results of RAPN when dealing with entirely central hilar masses and to examine the various methods used to address the surgical difficulties associated with them. Methods: A thorough literature search in September 2023 across various databases focused on RAPN for renal hilar masses, adhering to PRISMA guidelines. The primary goal was to evaluate RAPN’s surgical and functional outcomes, with a secondary aim of examining different surgical techniques. Out of 1250 records, 13 full-text manuscripts were reviewed. Results: Evidence is growing in favor of RAPN for renal hilar masses. Despite a predominance of retrospective studies and a lack of long-term data, RAPN shows positive surgical outcomes and preserves renal function without compromising cancer treatment effectiveness. Innovative suturing and clamping methods are emerging in surgical management. Conclusions: RAPN is a promising technique for managing renal hilar masses in RCC, offering effective surgical outcomes and renal function preservation. The study highlights the need for more long-term data and prospective studies to further validate these findings. Full article
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