Trends in the use of partial nephrectomy for cT1 renal tumors: Analysis of a 10-yr European multicenter dataset

被引：45

作者：

Simone, G. ^{[1
]}

De Nunzio, C. ^{[2
]}

Ferriero, M. ^{[1
]}

Cindolo, L. ^{[3
]}

Brookman-May, S. ^{[4
]}

Papalia, R. ^{[6
]}

Sperduti, I. ^{[1
]}

Collura, D. ^{[5
]}

Leonardo, C. ^{[1
,7
]}

Anceschi, U. ^{[1
]}

Tuderti, G. ^{[1
,7
]}

Misuraca, L. ^{[1
,7
]}

Dalpiaz, O. ^{[8
]}

Hatzl, S. ^{[8
]}

Lodde, M. ^{[9
]}

Trenti, E. ^{[9
]}

Pastore, A. L. ^{[10
]}

Palleschi, G. ^{[10
]}

Lotrecchiano, G. ^{[11
]}

Salzano, L. ^{[11
]}

Carbone, A. ^{[10
]}

De Cobelli, O. ^{[12
]}

Tubaro, A. ^{[2
]}

Schips, L. ^{[3
]}

Zigeuner, R. ^{[8
]}

Tostain, J. ^{[13
]}

May, M. ^{[14
]}

Guaglianone, S. ^{[1
]}

Muto, G. ^{[6
]}

Gallucci, M. ^{[1
]}

机构：

[1] Regina Elena Inst Canc Res, Rome, Italy

[2] Sapienza Univ, St Andrea Hosp, Rome, Italy

[3] Padre Pio da Pietrelcina Hosp, Vasto, Italy

[4] Ludwig Maximilians Univ Munchen, Munich, Germany

[5] San Giovanni Bosco Hosp, Turin, Italy

[6] Campus Biomed Univ, Rome, Italy

[7] Sapienza Univ, Policlin Umberto I, Rome, Italy

[8] Med Univ Graz, Graz, Austria

[9] Bolzano Gen Hosp, Bolzano, Italy

[10] Sapienza Univ, ICOT, Latina, Italy

[11] G Rummo Hosp, Benevento, Italy

[12] European Inst Oncol, Milan, Italy

[13] Univ St Etienne, St Etienne, France

[14] St Elisabeth Hosp Straubing, Straubing, Germany

来源：

EJSO | 2016年 / 42卷 / 11期

关键词：

Kidney cancer; Outcomes; Partial nephrectomy; Temporal trends; RADICAL NEPHRECTOMY; CELL CARCINOMA; NATIONAL TRENDS; UNITED-STATES; GUIDELINES; MANAGEMENT; MORTALITY; EPIDEMIOLOGY; ISCHEMIA; VOLUME;

D O I：

10.1016/j.ejso.2016.03.022

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Aim: Although extensively addressed in US registries, the utilization rate of Partial Nephrectomy has been poorly addressed in European settings. Our aim is to evaluate the impact of hospital volume on the use of PN for cT1 renal tumors. Methods: 2526 patients with cT1N0M0 renal tumors treated with either PN or radical nephrectomy at 10 European centres in the last decade were included in the analysis. Joinpoint regression analysis was used to identify significant changes over time in linear slope of the trend for each center. The correlation between yearly caseload and the slopes was assessed with the non-parametric Spearman test. Coincident pair wise tests and regression analyses were used to generate and compare the trends of high-volume (HV), mid-volume (MV) and low-volume (LV) groups. Results: Yearly caseload was significantly associated with increased use of PN (R = 0.69, p = 0.028). The utilization rate of PN was stable at LV centres (p = 0.67, p = 0.7, p = 0.76, for cT1, cT1 a, and cT1b tumors, respectively), while increased significantly at MV (p = 0.002, 0.0005 and 0.007, respectively) and HV centers (all p < 0.0001). Regression analysis confirmed the trends for HV and MV as significantly different from those observed in LV centres (all p <= 0.002) and highlighted significant differences also between MV and HV centres (all p <= 0.03). Conclusions: We confirmed the association between caseload and the use of PN for cT1 tumors. Our findings suggest that a minimum case-load might turn the tide also in LV centres while a selective referral to HV centers for cT1b tumors should be considered. (C) 2016 Elsevier Ltd. All rights reserved.

引用

页码：1729 / 1735

页数：7

共 27 条

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