دورية أكاديمية
The Temporal Association of Robotic Surgical Diffusion with Overtreatment of the Small Renal Mass.
| العنوان: | The Temporal Association of Robotic Surgical Diffusion with Overtreatment of the Small Renal Mass. |
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| المؤلفون: | Shah, P. H., Alom, M. A., Leibovich, B. C., Thompson, R. H., Uzzo, R. G., Kavoussi, L. R., Richstone, L., Bhindi, B., Habermann, E. B., Boorjian, S. A., +1 additional author |
| المصدر: | Journal Articles |
| بيانات النشر: | Donald and Barbara Zucker School of Medicine Academic Works |
| سنة النشر: | 2018 |
| المجموعة: | Hofstra Northwell Academic Works (Hofstra Northwell School of Medicine) |
| مصطلحات موضوعية: | Age Factors, Aged, 80 and over, Cohort Studies, Databases, Factual, Female, Humans, Kidney Neoplasms, Logistic Models, Male, Medical Overuse, Middle Aged, Multivariate Analysis, Neoplasm Invasiveness, Neoplasm Staging, Nephrectomy, Patient Safety, Prognosis, Retrospective Studies, Risk Assessment, Robotic Surgical Procedures, Watchful Waiting, Urology |
| الوصف: | 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 CONCLUSIONS: Robotic surgical extirpation has outpaced the adoption of active surveillance of small renal masses. This raises concern that the diffusion of robotic technology propagates overtreatment, particularly among elderly and comorbid individuals. |
| نوع الوثيقة: | text |
| اللغة: | unknown |
| العلاقة: | https://academicworks.medicine.hofstra.edu/publications/4245Test |
| DOI: | 10.1016/j.juro.2018.05.081 |
| الإتاحة: | https://doi.org/10.1016/j.juro.2018.05.081Test https://academicworks.medicine.hofstra.edu/publications/4245Test |
| رقم الانضمام: | edsbas.42B7476E |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.juro.2018.05.081 |
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