The Temporal Association of Robotic Surgical Diffusion with Overtreatment of the Small Renal Mass
The Temporal Association of Robotic Surgical Diffusion with Overtreatment of the Small Renal Mass
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DOI：
10.1016/j.juro.2018.05.081
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发表时间：
2018-11-01
影响因子：
6.6
通讯作者：
Boorjian, Stephen A.
中科院分区：
文献类型：
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作者：
Shah, Paras H.;Alom, Manaf A.;Boorjian, Stephen A.
目的：我们评估了当代的实践模式，在管理小肾masses.Materials和方法：我们确定了52,804例患者在NCDB（国家癌症数据库）谁被诊断为小肾肿块（4厘米或更小）在2010年和2014年之间。在所有患者、75岁或以上的老年患者和具有竞争性健康风险（定义为Charlson指数≥ 2）的个体中，比较了主动监测、消融和机器人、腹腔镜和开放手术技术的使用趋势。多变量逻辑回归模型被用来评估与机器人肾脏手术和主动surveillance.Results相关的因素：手术仍然是主要的治疗方式，在所有研究年份，在2010年和2014年分别进行了75.0%和74.2%的情况下。虽然主动监测从2010年的4.8%增加到2014年的6.0%（p
Purpose: We evaluated contemporary practice patterns in the management of small renal masses.Materials and Methods: We identified 52,804 patients in the NCDB (National Cancer Database) who were diagnosed with a small renal mass (4 cm or less) between 2010 and 2014. Utilization trends of active surveillance, ablation and robotic, laparoscopic and open surgical techniques were compared among all comers, elderly patients 75 years old or older and individuals with competing health risks, defined as a Charlson index of 2 or greater. Multivariable logistic regression models were used to assess factors associated with robotic renal surgery and active surveillance.Results: Surgery remained the primary treatment modality across all years studied, performed in 75.0% and 74.2% of cases in 2010 and 2014, respectively. Although increases in active surveillance from 4.8% in 2010 to 6.0% in 2014 (p