Purely Off-Clamp Laparoscopic Partial Nephrectomy Stands the Test of Time - 15 Years - functional and oncologic outcomes from a single center experience

Sep 24, 2026

Uploaded by OmBimo

Nephron-sparing surgery is the gold standard for organ-confined renal tumors, and this study reports 15-year outcomes following off-clamp laparoscopic partial nephrectomy (ocLPN). A retrospective analysis evaluated patients treated between May 2001 and December 2005, collecting demographic, clinical, pathologic, surgical, functional, and survival variables. Kaplan–Meier and log-rank testing assessed oncologic results at 5, 10, and 15 years, while Cox models identified predictors for renal function impairment and ROMeS.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Introduction

Materials and Methods

Patients and Dataset

Article Purely Off-Clamp Laparoscopic Partial Nephrectomy Stands the Test of Time: 15 Years Functional and Oncologic Outcomes from a Single Center Experience Aldo Brassetti 1, *, Umberto Anceschi 1, Alfredo Maria Bove 1, Francesco Prata 1, Manuela Costantini 1, Mariaconsiglia Ferriero 1, Riccardo Mastroianni 1, Leonardo Misuraca 1, Gabriele Tuderti 1, Giulia Torregiani 2, Marco Covotta 2, Michele Gallucci 1 and Giuseppe Simone 1 Citation: Brassetti, A.; Anceschi, U.; Bove, A.M.; Prata, F.; Costantini, M.; Ferriero, M.; Mastroianni, R.; Misuraca, L.; Tuderti, G.; Torregiani, G.; et al. Purely Off-Clamp Laparoscopic Partial Nephrectomy Stands the Test of Time: 15 Years Functional and Oncologic Outcomes from a Single Center Experience. Curr. Oncol. 2023, 30, 1196–1205 . [https://doi.org/10.3390/](https://doi.org/10.3390/)[ ](https://doi.org/10.3390/)curroncol30010092 Received: 27 December 2022 Revised: 9 January 2023 Accepted: 12 January 2023 Published: 15 January 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) . 1 Department of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy 2 Department of Anesthesiology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy * Correspondence: [aldo.brassetti@gmail.com](aldo.brassetti@gmail.com) Abstract: Background: Nephron-sparing surgery represents the gold standard treatment for organconﬁned renal tumors. We present 15-years of outcomes after off-clamp laparoscopic partial nephrectomy (ocLPN) . Methods: a retrospective analysis was performed on patients who underwent ocLPN between May 2001 and December 2005 . Baseline demographic, clinical, pathologic, surgical, functional and survival data were collected. The Kaplan–Meier method evaluated group-speciﬁc oncologic outcomes at 5, 10 and 15 years and the log rank test assessed differences between groups. The same analysis investigated the probabilities of developing a signiﬁcant renal function impairment (sRFI) and achieving ROMeS. Cox analyses identiﬁed predictors of this latter tricomposite outcome. Results: We included 63 patients whose median tumor size was 3 cm (IQR:2–4) . At 15 years, the chances of developing local recurrence, metachronous renal cancers or distant metastases were 2 􀀆 2%, 23 􀀆 6% and 17 􀀆 5%, respectively. Consequently, disease-free, cancer-speciﬁc and overall-survival probabilities were 68 􀀆 6%, 90 􀀆 4% and 72 􀀆 6% . MCRSS and UCISS well predicted oncologic outcomes. Overall, nine (14%) patients experienced an sRFI and 33 (52%) achieved ROMeS. Age (HR: 1.046; p = 0.033) and malignant histology (low-risk cancers HR: 3.233, p = 0.048) (intermediate/high risk cancers HR: 5.721, p = 0.023) were independent predictors of ROMeS non-achievement. Conclusions: At 15 years from ocLPN, most of patients will experience both excellent functional and oncologic outcomes. Keywords: laparoscopy; long term outcomes; partial nephrectomy; renal cancer; survival 1. Introduction Kidney cancer ranks among the most prevalent in the United States [1] and the vast majority are renal cell carcinomas (RCC) . Extirpative therapies have always been the mainstay treatment options but, as our understanding of cancer biology has matured, there has been a paradigm shift from radical nephrectomy to nephron-sparing surgery (NSS) and partial nephrectomy (PN) is nowadays considered the gold standard for organ-conﬁned diseases [2] . Clamping of the renal hilar vasculature is traditionally performed during PN to minimize bleeding and theoretically enhance surgical accuracy. To reduce the risk for ischemia-reperfusion injury, however, many different strategies were proposed such as of

FAQs

What time period and study type were used to evaluate ocLPN outcomes?

The study used a retrospective analysis of patients who underwent off-clamp laparoscopic partial nephrectomy between May 2001 and December 2005.

How were oncologic outcomes assessed over long-term follow-up?

Kaplan–Meier methods evaluated oncologic outcomes at 5, 10, and 15 years, and the log-rank test compared group-specific differences.

What factors were identified as independent predictors related to ROMeS non-achievement?

Age (HR 1.046; p=0.033) and malignant histology were independent predictors, with higher hazard for low-risk and for intermediate/high-risk cancers in the reported analyses.

Sep 24, 2026

Uploaded by OmBimo