To perform an external validation of this RC-pentafecta.
Between January 2014 and December 2019, 104 consecutive patients who underwent RARC with ICUD within 6 urological centers were analyzed retrospectively. Patients who simultaneously demonstrated negative soft tissue surgical margins (STSMs), a lymph node (LN) yield ≥ 16, absence of major (Clavien-Dindo grade III-V) 90-day postoperative complications, absence of UD-related long-term sequelae, and absence of 12-month clinical recurrence were considered to have achieved RC-pentafecta. A multivariable logistic regression model was used to measure predictors for achieving RC-pentafecta. We analyzed the influence of this RC-pentafecta on survival, and the impact ofthe surgical experience.
Since 2014, 104 patients who had completed at least 12 months of follow-up were included. Over a mean follow-up of 18 months, a LN yield ≥ 16, negative STSMs, absence of major complications at 90 days, and absence of UD-related surgical sequelae and clinical recurrence at ≤ 12 months were observed in 56%, 96%, 85%, 81%, and 91% of patients, respectively, resulting in a RC-pentafecta rate of 39.4%. Multivariate analysis showed that age was an independent predictor of pentafecta achievement (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.90. 0.99; p = 0.04). The surgeon experience had an impact on the validation of the criteria.
This study confirmed that the RC-pentafecta is reproducible and could be externally used for the outcome assessment after RARC with ICUD. Therefore, the RC-pentafecta could be a useful tool to assess surgical success and its impact on different outcomes.
World journal of urology. 2021 Jul 03 [Epub ahead of print]
P Baron, Z Khene, F Lannes, G Pignot, A S Bajeot, G Ploussard, G Verhoest, A Gasmi, O Perrot, M Roumiguie, K Mori, G E Cacciamani, M Rouprêt, F Bruyère, B Pradere
Department of Urology, University Hospital of Tours, Loire Valley, Tours, France., Department of Urology, Rennes University Hospital, Rennes, France., Service de Chirurgie Oncologique 2, Institut Paoli-Calmettes, Marseille, France., Department of Urology, Andrology and Renal Transplantation, CHU Rangueil, Toulouse, France., Department of Urology, Clinique La Croix du Sud, Toulouse, France., Department of Urology, Sorbonne Université, GRC no 5, predictive onco-urology, AP-HP, Hôpital Pitié-Salpêtrière, Urology, 75013, Paris, France., Department of Urology, The Jikei University School of Medicine, Tokyo, Japan., USC Institute of Urology, University of Southern California, Los Angeles, CA, USA., Department of Urology, University Hospital of Tours, Loire Valley, Tours, France. .