1.A single-center analysis of the short-term efficacy and safety of RAPN in 45 patients with non-metastatic pT 3a renal cell carcinoma
Xiangpeng ZOU ; Yunhan LUO ; Zhiling ZHANG ; Zhaohui ZHOU ; Longbin XIONG ; Yulu PENG ; Yixin HUANG ; Xin LUO ; Wensu WEI ; Zhenhua LIU ; Pei DONG ; Shengjie GUO ; Hui HAN ; Fangjian ZHOU
Chinese Journal of Urology 2025;46(5):369-375
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.
2.A single-center analysis of the short-term efficacy and safety of RAPN in 45 patients with non-metastatic pT 3a renal cell carcinoma
Xiangpeng ZOU ; Yunhan LUO ; Zhiling ZHANG ; Zhaohui ZHOU ; Longbin XIONG ; Yulu PENG ; Yixin HUANG ; Xin LUO ; Wensu WEI ; Zhenhua LIU ; Pei DONG ; Shengjie GUO ; Hui HAN ; Fangjian ZHOU
Chinese Journal of Urology 2025;46(5):369-375
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.
3.Relation factor analysis for the short-term preservation of ipsilateral renal function after partial nephrectomy
Yixin HUANG ; Xiangpeng ZOU ; Zhiling ZHANG ; Kang NING ; Xin LUO ; Longbin XIONG ; Yulu PENG ; Zhaohui ZHOU ; Pei DONG ; Shengjie GUO ; Hui HAN ; Fangjian ZHOU
Chinese Journal of Surgery 2023;61(12):1099-1103
Objectives:To analyze the factors relative to the short-term preservation of ipsilateral renal function after partial nephrectomy.Methods:The clinical data of 83 patients who were treated with partial nephrectomy from December 2014 to December 2019 in the Department of Urology, Sun Yat-sen University Cancer Center were retrospectively analyzed. There were 54 males and 29 females, aging ( M (IQR)) 49 (17) years (range: 27 to 74 years). The ischemia time in operation was 25 (18) minutes (range: 10 to 67 minutes). Emission computed tomography scan and CT scan were performed before (within 1 month) and after (3 to 12 months) surgery. The volume of the ipsilateral and contralateral kidney was measured on the basis of preoperative and postoperative CT scans. The glomerular filtration rate (GFR) specifically in each kidney was estimated by emission computed tomography. Recovery from ischemia is determined by the formula: GFR preservation/volume saved×100%. Linear regression was used to explore the factors ralative to the short-term preservation of ipsilateral renal function after partial nephrectomy. Results:The GFR preservation of the ipsilateral kidney was 80.9 (25.2) % (range: 31.0% to 109.4%). The volume loss of the kidney resulted in a decrease of 12.0% (5.8 ml/(min×1.96 m 2)) of GFR, while the ischemic injury resulted in a decrease of 6.5% (2.5 ml/(min×1.96 m 2)) of GFR. The volume saved from the ipsilateral kidney was 87.1 (12.9) % (range: 27.0% to 131.7%). Recovery from ischemia was 93.5 (17.5) % (range:44.3% to 178.3%). In multivariate analysis, GFR preservation of the ipsilateral kidney was significantly correlated with the volume saved of the ipsilateral kidney ( β=0.383, 95% CI: 0.144 to 0.622, P=0.002). It was not related to the ischemia time ( β=0.046, 95% CI:-0.383 to 0.475, P=0.831). Conclusion:In the condition of limited ischemic time, in the short term ipsilateral renal function after partial nephrectomy is mainly determined by the loss of kidney volume, while ischemic injury only plays a minor role.
4.Relation factor analysis for the short-term preservation of ipsilateral renal function after partial nephrectomy
Yixin HUANG ; Xiangpeng ZOU ; Zhiling ZHANG ; Kang NING ; Xin LUO ; Longbin XIONG ; Yulu PENG ; Zhaohui ZHOU ; Pei DONG ; Shengjie GUO ; Hui HAN ; Fangjian ZHOU
Chinese Journal of Surgery 2023;61(12):1099-1103
Objectives:To analyze the factors relative to the short-term preservation of ipsilateral renal function after partial nephrectomy.Methods:The clinical data of 83 patients who were treated with partial nephrectomy from December 2014 to December 2019 in the Department of Urology, Sun Yat-sen University Cancer Center were retrospectively analyzed. There were 54 males and 29 females, aging ( M (IQR)) 49 (17) years (range: 27 to 74 years). The ischemia time in operation was 25 (18) minutes (range: 10 to 67 minutes). Emission computed tomography scan and CT scan were performed before (within 1 month) and after (3 to 12 months) surgery. The volume of the ipsilateral and contralateral kidney was measured on the basis of preoperative and postoperative CT scans. The glomerular filtration rate (GFR) specifically in each kidney was estimated by emission computed tomography. Recovery from ischemia is determined by the formula: GFR preservation/volume saved×100%. Linear regression was used to explore the factors ralative to the short-term preservation of ipsilateral renal function after partial nephrectomy. Results:The GFR preservation of the ipsilateral kidney was 80.9 (25.2) % (range: 31.0% to 109.4%). The volume loss of the kidney resulted in a decrease of 12.0% (5.8 ml/(min×1.96 m 2)) of GFR, while the ischemic injury resulted in a decrease of 6.5% (2.5 ml/(min×1.96 m 2)) of GFR. The volume saved from the ipsilateral kidney was 87.1 (12.9) % (range: 27.0% to 131.7%). Recovery from ischemia was 93.5 (17.5) % (range:44.3% to 178.3%). In multivariate analysis, GFR preservation of the ipsilateral kidney was significantly correlated with the volume saved of the ipsilateral kidney ( β=0.383, 95% CI: 0.144 to 0.622, P=0.002). It was not related to the ischemia time ( β=0.046, 95% CI:-0.383 to 0.475, P=0.831). Conclusion:In the condition of limited ischemic time, in the short term ipsilateral renal function after partial nephrectomy is mainly determined by the loss of kidney volume, while ischemic injury only plays a minor role.
5.Analysis of robot-assisted laparoscopic versus laparoscopic partial nephrectomy for the treatment of completely endophytic renal tumors
Luyao CHEN ; Situ XIONG ; Wen DENG ; Yunqiang XIONG ; Tao CHEN ; Xiangpeng ZHAN ; Weipeng LIU ; Jin ZENG ; Jing XIONG ; Gongxian WANG ; Bin FU
Chinese Journal of Urology 2022;43(5):335-338
Objective:To compare the efficacy and safety of robot-assisted laparoscopic and laparoscopic partial nephrectomy (RAPN and LPN) for patients with completely endophytic renal tumor.Methods:A total of 73 patients with completely endophytic renal tumor receiving RAPN (n=29) or LPN (n=44) in our center between January 2015 and June 2021 were retrospectively collected. There were 21 males and 8 females in RAPN group. The average age was 48.6±13.7 years old, average tumor size was 2.9±0.9 cm with 13 left tumors and 16 right tumors, average R. E.N.A.L. score was 9.2±1.0, and average preoperative eGFR was 82.6±10.7 ml/(min·1.73 m 2). There were 27 males and 17 females in LPN group. The average age was 50.1±12.3 years old, average tumor size was 2.9±0.9 cm with 24 left tumors and 20 right tumors, average R. E.N.A.L. score was 9.1±1.3, and average preoperative eGFR was 81.7±9.6 ml/(min·1.73 m 2). There was no significant difference in above variables between two groups. The operative time, warm ischemia time, blood loss, postoperative complication, postoperative hospital stay and postoperative 3 months renal function of two groups were compared. Results:All 73 patients successfully underwent RAPN or LPN and no patient converted to radical nephrectomy or open surgery. There was no significant difference in operation time [140(80, 160) min vs. 150 (90, 180) min, P=0.264], intraoperative estimated blood loss[150 (100, 200)vs. 180 (120, 200) ml, P=0.576]and postoperative hospital stay (7.0±2.7 vs. 7.4±2.1 days, P=0.480) between two groups. Compared with LPN group, RAPN group had obvious less warm ischemia time (23.1±3.3 vs. 27.6±4.7 min, P<0.001). No obvious complication occurred in RAPN group and one case with postoperative hemorrhage occurred in LPN group. No positive margin occurred in either group. There was no difference in renal function 3 months after operation between the two groups [73.2±6.3 vs.70.5±7.6ml/(min·1.73 m 2), P=0.117]. The median follow-up period was 22.6 months with no tumor recurrence or metastasis. Conclusions:For experienced surgeons, both RAPN and LPN are safe and feasible for patients with completely endophytic renal tumor. Compared with LPN, RAPN has advantages of perioperative curative effect, which could reduce the operating difficulty and shorten the warm ischemia time.
6.Expression of microRNA-100 and its correlation with drug resistance in human ovarian cancer SKOV3/DDP cells.
Peng GUO ; Dongxian PENG ; Xiangpeng XIONG ; Sainan ZHANG
Journal of Southern Medical University 2015;35(11):1624-1627
OBJECTIVETo investigate the expression of microRNA-100(miR-100) and the relationship with cisplatin resistance in human ovarian epithelial cancer SKOV3/DDP cells.
METHODSThe SKOV3/DDP cells were transfected with the mimics or inhibitor of miR-100 or negative control RNA (NC) or inhibitor negative control RNA (inhibitor NC) by lipofectamine 2000. The experiment was divided into six groups: SKOV3 group, SKOV3/DDP group, miR-100 mimices group, NC group, miR-100 inhibitor group and inhibitor NC group. The expression of miR-100 and the cisplatin IC50 were measured by real-time PCR and CCK8 assay respectively.
RESULTS(1)The cisplatin resistance index of SKOV3/DDP was 2.23; (2)The express level of miR-100 in SKOV3/DDP cells was significantly lower than that in SKOV3 cells (P<0.001); (3)After transfected with miR-100 mimics, SKOV3/DDP cells showed that the level of miR-100 was 38.29 times higher than that in the NC group(P<0.01). The cisplatin IC50 of miR-100 mimices group was significantly lower than that in the NC group (P<0.001); (4) After transfected with miR-100 inhibitor, the level of miR-100 0f SKOV3/DDP was decreased by 97.7%. The cisplatin IC50 of miR-100 inhibitor group was significantly increased as compared with that in the inhibitor NC group (P<0.001).
CONCLUSIONThe expression of miR-100 is downregulated in SKOV3/DDP cells. Overexpressing miR-100 may effectively increase the sensitivity to cisplatin of human ovarian epithelial cancer SKOV3/DDP cells and may reverse cisplatin-resistance of EOC (epithelial ovarian cancer).
Antineoplastic Agents ; Cell Line, Tumor ; Cisplatin ; pharmacology ; Down-Regulation ; Drug Resistance, Neoplasm ; Female ; Humans ; MicroRNAs ; metabolism ; Neoplasms, Glandular and Epithelial ; metabolism ; pathology ; Ovarian Neoplasms ; metabolism ; pathology ; Real-Time Polymerase Chain Reaction ; Transfection

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