A single-center analysis of the short-term efficacy and safety of RAPN in 45 patients with non-metastatic pT 3a renal cell carcinoma
10.3760/cma.j.cn112330-20250208-00047
- VernacularTitle:单中心45例RAPN治疗非转移性pT 3a期肾细胞癌的短期疗效与安全性分析
- Author:
Xiangpeng ZOU
1
;
Yunhan LUO
1
;
Zhiling ZHANG
1
;
Zhaohui ZHOU
1
;
Longbin XIONG
1
;
Yulu PENG
1
;
Yixin HUANG
1
;
Xin LUO
1
;
Wensu WEI
1
;
Zhenhua LIU
1
;
Pei DONG
1
;
Shengjie GUO
1
;
Hui HAN
1
;
Fangjian ZHOU
1
Author Information
1. 中山大学肿瘤防治中心 华南恶性肿瘤防治全国重点实验室 肿瘤医学协同创新中心泌尿外科，广州 510060
- Publication Type:Journal Article
- Keywords:
Carcinoma，renal cell;
Stage T 3a;
Robot;
Partial nephrectomy;
Safety;
Prognosis;
Renal function
- From:
Chinese Journal of Urology
2025;46(5):369-375
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the short-term efficacy and safety of robot-assisted laparoscopic partial nephrectomy（RAPN）for non-metastatic pathological stage T 3a renal cell carcinoma. Methods:The clinical and pathological data of 45 patients with pathologically confirmed non-metastatic T 3a renal cell carcinoma who underwent RAPN at Sun Yat-sen University Cancer Center between January 2016 and December 2023 were retrospectively reviewed. There were 30 males and 15 females. The average age of the cohort was（54.3±10.7）years，and the average clinical tumor diameter was（4.9±1.8）cm. Of all the patients，35（77.8%）were asymptomatic，7（15.6%）presented with hematuria，and 3（6.7%）presented with lumbar pain. Preoperative imaging assessed 34 patients（75.6%）as having clinical stage T 3a，all suspected of involving the collecting system or perirenal fat invasion；the remaining 11 patients（24.4%）were assessed as having stage T 1-2 disease. The median R.E.N.A.L. nephrectomy score was 8.0（7.0，10.0）. A history of hypertension，diabetes，or chronic kidney disease was present in 18 patients（40.0%）. The primary endpoint was progression-free survival，and the secondary endpoints included postoperative complications and short-term renal function outcomes. Survival curve was estimated using the Kaplan-Meier method，and renal function comparisons were made using the paired t-test. Results:The RAPN was performed through a transabdominal approach in 32 patients（71.1%），with a median estimated blood loss of 150.0（50.0，300.0）ml. Seven（15.6%）patients required intraoperative blood transfusion. The median length of postoperative hospital stay was 4.0（4.0，6.0）days. Postoperative complications occurred in 6 patients（13.3%），including 5（11.1%）with mild complications and 1（2.2%）with a severe complication. Renal function returned to baseline in 24 of 39 evaluable patients（61.5%），while 3 patients（7.7%）developed surgery-related chronic kidney disease 3 to 12 months postoperatively，but none required dialysis. The median follow-up time was 31.8（22.7，50.9）months，12（26.7%）patients received programmed cell death protein 1 inhibitor adjuvant therapy postoperatively. During follow-up，3 patients experienced tumor recurrence，the 3-year progression-free survival rate of the entire cohort was 95.4%.Conclusions:For some carefully selected patients with T 3a renal cell carcinoma，RAPN performed by experienced surgeons is a feasible and safe option，providing excellent short-term oncological outcomes，complication control，and renal function recovery. The long-term efficacy remains to be seen.
