Evidence map›Paper›PMID 40439733›Full record

SynthesisWorld journal of urology2025

Robot-assisted partial nephrectomy for localized renal masses in elderly and younger patients: a systematic review and meta-analysis of perioperative outcomes.

Alejandro Calvillo-Ramirez, Lauren Chew, Jessica Edith Acevedo-Rodriguez, Andrea G Palacios-Navas, Carlos E Vidal-Valderrama, Lee Ponsky, Randy Vince

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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

7 authors.

Alejandro Calvillo-RamirezDepartment of Urology, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA. alejandro.calvilloramirez@uhhospitals.org.ORCID https://orcid.org/0009-0005-6983-9116
Lauren ChewDepartment of Urology, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
Jessica Edith Acevedo-RodriguezTecnologico de Monterrey, Escuela de Medicina, Zapopan, Jalisco, Mexico.
Andrea G Palacios-NavasUniversidad de Guayaquil, Guayaquil, Ecuador.
Carlos E Vidal-ValderramaFacultad de Medicina, Universidad Autonoma de Baja California, Ensenada, Baja California, Mexico.
Lee PonskyDepartment of Urology, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
Randy VinceDepartment of Urology, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRobot-assisted partial nephrectomy (RAPN) is an established treatment modality for localized renal masses (LRMs). Nevertheless, its applicability in aging populations presents unique challenges, with limited existing evidence. This meta-analysis aims to evaluate the safety and feasibility of RAPN for LRMs in elderly patients compared to younger individuals.

methodsDatabases were searched until August 2024 to identify articles comparing RAPN outcomes in elderly and younger patients. Studies were stratified based on age cutoffs for older individuals. Three primary cutoffs were employed for subgroup analysis: 70-74, 75-79, and ≥ 80 years old. Primary outcomes included the incidence of any grade and major complications (Clavien-Dindo ≥ 3) and trifecta achievement. Odds ratios (OR) and mean differences (MD) were used for statistical comparisons.

resultsSeven studies comprising 5,937 patients were included. A significantly higher incidence of any grade complications was observed in elderly patients (OR 1.38 [95%confidence interval [CI] 1.03, 1.84], p = 0.02). However, there was no difference in major complications (OR 1.32 [95%CI 0.79, 2.18], p = 0.28) or trifecta achievement (OR 1.02 [95%CI 0.83, 1.25], p = 0.84) between elderly and younger patients. Similarly, estimated blood loss, transfusion rates, positive surgical margins, and operative time were comparable between groups. Notably, elderly individuals had a shorter warm ischemia time (MD -1.59 [95%CI -2.40, -0.79], p < 0.001).

conclusionsRAPN appears to be a viable treatment option for well-selected elderly patients with LRMs who are candidates for active treatment. While elderly patients experienced higher rates of minor complications, major complications and trifecta achievement were comparable to those of younger patients.

Indexed as

Kidney NeoplasmsNephrectomyRobotic Surgical ProceduresAgedAged, 80 and overAge FactorsHumansPostoperative ComplicationsTreatment OutcomeAgedElderlyRenal massRobot-assisted partial nephrectomyRobot-assisted surgerySystematic review

Identifiers

What OpenQuestion holds

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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.