Evidence map›Paper›PMID 38896165›Full record

ArticleJournal of robotic surgery2024

Adoption of robot-assisted radical nephroureterectomy permits a minimally invasive option for management of upper tract urothelial carcinoma in geriatric patients: comparison with non-geriatric patients with intermediate-term oncologic follow-up.

Justin M Refugia, Parth U Thakker, Timothy K O'Rourke, Adam Cohen, Aaron Bradshaw, Randy Casals, Maxwell Sandberg, Wyatt Whitman, Sumit Saini, Ashok K Hemal

Abstract readComparative Study
In one paragraph

Article in Journal of robotic surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Justin M RefugiaDepartment of Urology, Atrium Health Wake Forest Baptist Medical Center, 140 Charlois Boulevard, Winston-Salem, NC, 27103, USA. jrefugia@wakehealth.edu.
Parth U ThakkerDepartment of Urology, Atrium Health Wake Forest Baptist Medical Center, 140 Charlois Boulevard, Winston-Salem, NC, 27103, USA.
Timothy K O'RourkeDepartment of Urology, Atrium Health Wake Forest Baptist Medical Center, 140 Charlois Boulevard, Winston-Salem, NC, 27103, USA.
Adam CohenDepartment of Urology, Atrium Health Wake Forest Baptist Medical Center, 140 Charlois Boulevard, Winston-Salem, NC, 27103, USA.
Aaron BradshawDepartment of Urology, Atrium Health Wake Forest Baptist Medical Center, 140 Charlois Boulevard, Winston-Salem, NC, 27103, USA.
Randy CasalsDepartment of Urology, Atrium Health Wake Forest Baptist Medical Center, 140 Charlois Boulevard, Winston-Salem, NC, 27103, USA.
Maxwell SandbergDepartment of Urology, Atrium Health Wake Forest Baptist Medical Center, 140 Charlois Boulevard, Winston-Salem, NC, 27103, USA.
Wyatt WhitmanDepartment of Urology, Atrium Health Wake Forest Baptist Medical Center, 140 Charlois Boulevard, Winston-Salem, NC, 27103, USA.
Sumit SainiDepartment of Urology, Atrium Health Wake Forest Baptist Medical Center, 140 Charlois Boulevard, Winston-Salem, NC, 27103, USA.
Ashok K HemalDepartment of Urology, Atrium Health Wake Forest Baptist Medical Center, 140 Charlois Boulevard, Winston-Salem, NC, 27103, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

To assess the oncologic efficacy and safety of robot-assisted approach to radical nephroureterectomy (RARNU) in geriatric versus younger patients with upper tract urothelial carcinoma (UTUC). A single-center, retrospective cohort study was conducted from 2009 to 2022 of 145 patients (two cohorts: < 75 and ≥ 75 years old) with non-metastatic UTUC who underwent RARNU. Primary endpoint was UTUC-related recurrence of disease during surveillance (bladder-specific and metastatic). Safety was assessed according to 30-day, modified Clavien-Dindo (CD) classifications (Major: C.D. III-V). Survival estimates were performed using Kaplan-Meier method. There were 89 patients < 75 years (median 65 years) and 56 patients ≥ 75 years (median 81 years). Comparing the young versus geriatric cohorts: median follow-up 38 vs 24 months (p = 0.03, respectively) with similar 3-year bladder-specific recurrence survival (60% vs 67%, HR 0.70, 95% CI [0.35, 1.40], p = 0.31) and metastasis-free survival (79% vs 70%, HR 0.71, 95% CI [0.30, 1.70], p = 0.44). Expectedly, the younger cohort had a significant deviation in overall survival compared to the geriatric cohort at 1-year (89% vs 76%) and 3-years (72% vs 41%; HR 3.29, 95% CI [1.88, 5.78], p < 0.01). The 30-day major (1% vs 0) and minor complications (8% vs 14%, p = 0.87). Limitations include retrospective study design of a high-volume, single-surgeon experience. Compared to younger patients with UTUC, geriatric patients undergoing RARNU have similar oncologic outcomes at intermediate-term follow-up with no increased risk of 30-day perioperative complications. Thus, age alone should not be used to disqualify patients from definitive surgical management of UTUC with RARNU.

Indexed as

NephroureterectomyRobotic Surgical ProceduresAgedAged, 80 and overAge FactorsCarcinoma, Transitional CellFemaleFollow-Up StudiesHumansKidney NeoplasmsMaleMiddle AgedMinimally Invasive Surgical ProceduresNeoplasm Recurrence, LocalRetrospective StudiesTreatment OutcomeGeriatric oncologyMinimally invasive surgeryNephroureterectomyRobot-assistedUpper tract urothelial carcinoma

Identifiers

PMID38896165
PMCPMC11186893

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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.