Evidence map›Paper›PMID 32885379›Full record

Observational studyJournal of robotic surgery2021

Robotic-assisted partial nephrectomy (RAPN) and standardization of outcome reporting: a prospective, observational study on reaching the "Trifecta and Pentafecta".

D Sri, R Thakkar, H R H Patel, J Lazarus, F Berger, R McArthur, H Lavigueur-Blouin, M Afshar, C Fraser-Taylor, P Le Roux and 2 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of robotic surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed.

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  12. [Treatment outcome of laparoscopic partial nephrectomy in patients with renal tumors of moderate to high complexity].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

D SriSt George's Hospital NHS Trust, Tooting, London, SW17 0QT, UK. denosshansri@gmail.com.ORCID http://orcid.org/0000-0002-6016-0597
R ThakkarSt George's Hospital NHS Trust, Tooting, London, SW17 0QT, UK.
H R H PatelSt George's Hospital NHS Trust, Tooting, London, SW17 0QT, UK.
J LazarusSt George's Hospital NHS Trust, Tooting, London, SW17 0QT, UK.
F BergerSt George's Hospital NHS Trust, Tooting, London, SW17 0QT, UK.
R McArthurSt George's Hospital NHS Trust, Tooting, London, SW17 0QT, UK.
H Lavigueur-BlouinSt George's Hospital NHS Trust, Tooting, London, SW17 0QT, UK.
M AfsharSt George's Hospital NHS Trust, Tooting, London, SW17 0QT, UK.
C Fraser-TaylorSt George's Hospital NHS Trust, Tooting, London, SW17 0QT, UK.
P Le RouxSt George's Hospital NHS Trust, Tooting, London, SW17 0QT, UK.
J LibanSt George's Hospital NHS Trust, Tooting, London, SW17 0QT, UK.
C J AndersonSt George's Hospital NHS Trust, Tooting, London, SW17 0QT, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Partial nephrectomy (PN) for small renal masses is common, but outcomes are not reported in a standard manner. Traditionally, parameters such as 90-day mortality, blood loss, transfusion rates, length of stay, nephrometry scoring and complications are published but their collective impact on warm ischemia time (WIT) and post-surgery GFR is rarely determined. Thus, our aim was to assess if "Trifecta" and "Pentafecta" outcomes could be used as useful surgical outcome markers. A prospective database of 252 Robotic-Assisted PN (RAPN) cases (2008-2019) was analysed. "Pentafecta" was defined as achievement of "Trifecta" (negative surgical margin, no postoperative complications and WIT of < 25 min) plus over 90% estimated GFR preservation and no CKD stage upgrading at 1 year. Binary logistic regression analysis was conducted to predict factors which may prevent achieving a Trifecta/Pentafecta. Median tumour size was 3 cm and mean WIT was 15 min. Positive surgical margins (PSM) occurred in 2 cases. Overall, the intra-operative complication rate was 7%. One recurrence conferred 5-year cancer-free survival of 97%. Trifecta outcome was achieved in 169 (67%) and Pentafecta in 141 (56%) of cases. At logistic regression analysis, intraoperative blood loss was the only factor to affect Trifecta achievement (p = 0.018). Advanced patient age negatively impacted Pentafecta achievement (p = 0.010). The Trifecta and Pentafecta outcomes are easily applicable to PN data, and offer an internationally comparable PN outcome, quality measure. We recommend applying this standardization to national data collection to improve the quality of reporting and ease of interpretation of surgeon/centres' outcomes.

Indexed as

Kidney NeoplasmsRobotic Surgical ProceduresHumansNeoplasm Recurrence, LocalNephrectomyReference StandardsRetrospective StudiesTreatment OutcomePartial nephrectomyPentafectaRobot-assisted partial nephrectomyTrifecta

Identifiers

PMID32885379
PMCPMC8295154

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.