PD10-12 CLINICAL OUTCOMES FOLLOWING LAPAROSCOPIC MANAGEMENT OF PT3 RENAL MASSES: A MULTI-INSTITUTIONAL ANALYSIS
Bibliographic record
Abstract
You have accessJournal of UrologyKidney Cancer: Evaluation/Staging I1 Apr 2014PD10-12 CLINICAL OUTCOMES FOLLOWING LAPAROSCOPIC MANAGEMENT OF PT3 RENAL MASSES: A MULTI-INSTITUTIONAL ANALYSIS Jasmir Nayak, Premal Patel, Kamaljot Kaler, Zhihui Liu, Anil Kapoor, Ricardo Rendon, Simon Tanguay, Peter Black, Jun Kawakami, Rodney Breau, Antonio Finelli, Laurence Klotz, and Darrel Drachenberg Jasmir NayakJasmir Nayak More articles by this author , Premal PatelPremal Patel More articles by this author , Kamaljot KalerKamaljot Kaler More articles by this author , Zhihui LiuZhihui Liu More articles by this author , Anil KapoorAnil Kapoor More articles by this author , Ricardo RendonRicardo Rendon More articles by this author , Simon TanguaySimon Tanguay More articles by this author , Peter BlackPeter Black More articles by this author , Jun KawakamiJun Kawakami More articles by this author , Rodney BreauRodney Breau More articles by this author , Antonio FinelliAntonio Finelli More articles by this author , Laurence KlotzLaurence Klotz More articles by this author , and Darrel DrachenbergDarrel Drachenberg More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.488AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Technological advances and improved experience have resulted in advanced renal masses being treated by minimally invasive techniques. We report on the oncological outcomes of patients with non-metastatic renal masses with vascular invasion (pT3) who were treated with laparoscopic nephrectomy (LN) and/or caval thrombectomy. METHODS Institutional databases on patients treated surgically for renal cell carcinoma (RCC) were obtained from 14 centres across 6 Canadian provinces forming the Canadian Kidney Cancer Information System (CKCis) database. Data were collected on 2204 patients and included patient characteristics, peri-operative information, as well as pathological and oncological outcomes. RESULTS Of the 2204 patients, 498 (22.6%) patients had pT3 disease according to the 2009 TNM staging system. 173 (35%) patients underwent laparoscopic management, of which 135 (27%) did not have evidence of metastatic disease at the time of surgery. Mean age was 65 (range 35-88) with a higher propensity of male patients (n=87, 64%). Median tumor size was 6.5 cm (range 1 - 15 cm). The pre-operative clinical stage ranged from cT1-cT4. Average blood loss was 266 ml (range 0-4000 ml) with a mean operative time of 146 minutes (range 73-360 minutes). The majority of lesions were clear cell RCC (68%). Of the pT3 lesions, there were no peri-operative deaths (<30 days). After a median follow-up of 1.4 years, 31 (23%) patients developed metastatic disease, the vast majority being of pulmonary origin (97%). At the end of our follow-up period 130 (96%) patients were alive. CONCLUSIONS For properly selected patients, laparoscopic management of locally advanced renal masses yields acceptable oncological outcomes. Although encouraging, longer follow-up is required to further delineate its role. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e286 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Jasmir Nayak More articles by this author Premal Patel More articles by this author Kamaljot Kaler More articles by this author Zhihui Liu More articles by this author Anil Kapoor More articles by this author Ricardo Rendon More articles by this author Simon Tanguay More articles by this author Peter Black More articles by this author Jun Kawakami More articles by this author Rodney Breau More articles by this author Antonio Finelli More articles by this author Laurence Klotz More articles by this author Darrel Drachenberg More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".