An International Delphi Consensus About Tumor Rupture During Robotic Partial Nephrectomy (Researching UnPredictable TUmor RupturE during Robotic Partial Nephrectomy-The RUPTURE Project)

Background and objective: Tumor rupture during robot-assisted partial nephrectomy (RAPN) poses oncological risks, including potential malignant cell spread and recurrence. Despite these risks, standardized guidelines for defining, managing, and assessing risk factors of tumor rupture in RAPN are lac...

ver descrição completa

Detalhes bibliográficos
Autores: Bertolo, R, Antonelli, A, Bex, A, Anderson, C, Autorino, R, Barber, N, Badani, K, Barod, R, Bensalah, K, Bernhard, JC, Breda, A, Capitanio, U, Challacombe, B, Crivellaro, S, De Groote, R, Derweesh, I, Galfano, A, Harke, N, Kaouk, J, Kutikov, A, Maes, K, Minervini, A, Maresma, MCM, Montorsi, F, Porpiglia, F, Porter, J, Schiavina, R, Siemer, S, Simone, G, Touijer, K, Vaessen, C, Volpe, A, Wu, ZJ, Zondervan, P, Russo, P, Ribal, MJ, Mottrie, A
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Recursos:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p20380
Acesso em linha:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=20380
Access Level:acceso abierto
Palavra-chave:Renal neoplasm
Nephrectomy
Rupture
Delphi
id ES_49b189b4e3f2ee9c1b7b3e72a415653b
oai_identifier_str oai:iibsantpau.fundanetsuite.com:p20380
network_acronym_str ES
network_name_str España
repository_id_str
spelling An International Delphi Consensus About Tumor Rupture During Robotic Partial Nephrectomy (Researching UnPredictable TUmor RupturE during Robotic Partial Nephrectomy-The RUPTURE Project)Bertolo, RAntonelli, ABex, AAnderson, CAutorino, RBarber, NBadani, KBarod, RBensalah, KBernhard, JCBreda, ACapitanio, UChallacombe, BCrivellaro, SDe Groote, RDerweesh, IGalfano, AHarke, NKaouk, JKutikov, AMaes, KMinervini, AMaresma, MCMMontorsi, FPorpiglia, FPorter, JSchiavina, RSiemer, SSimone, GTouijer, KVaessen, CVolpe, AWu, ZJZondervan, PRusso, PRibal, MJMottrie, ARenal neoplasmNephrectomyRuptureDelphiBackground and objective: Tumor rupture during robot-assisted partial nephrectomy (RAPN) poses oncological risks, including potential malignant cell spread and recurrence. Despite these risks, standardized guidelines for defining, managing, and assessing risk factors of tumor rupture in RAPN are lacking. This Delphi consensus study aimed to frame the definition, risk factors, and oncological implications of tumor rupture in RAPN, as well as to propose management strategies. Methods: Using a modified Delphi method, a steering committee from multiple urological societies (the RUPTURE project) led a consensus-building study that followed the ACcurate COnsensus Reporting Document (ACCORD) checklist. A panel of international experts participated in a two-phase Delphi survey, rating their agreement with statements on tumor rupture, risk factors, and management in RAPN. Consensus was defined as >= 70% agreement, with unresolved statements discussed in an online meeting and subjected to a second voting round. Key findings and limitations: Thirty-three experts evaluated 58 statements. Consensus was reached on 33% of statements in the first round and 37.5% in the second round. Tumor rupture was defined, with risk factors including larger tumor size, complexity, and endophytic growth patterns. Recommended management strategies focused on minimizing tumor spillage by suctioning-rather than grasping-the cancerous tissue, and promptly securing the specimen in an endobag. Routine conversion to radical nephrectomy was not advised unless unresectable tumor remnants were found. Tumor rupture was not linked to distant metastasis, although its oncological impact varied by the rupture extent (ie, gross rupture vs focal; tumor spilled out macroscopically completely removed vs not). Conclusions and clinical implications: This consensus forms a basis for future research on tumor rupture in RAPN, emphasizing standardized definitions and uniform management strategies. Empirical validation through future clinical research is warranted. Patient summary: This research looks at tumor rupture during robotic kidney surgery, which can happen but is rare. The study involved a panel of experts who discussed finding a consensus on when it is more likely to occur and how to manage it effectively to reduce risks. It was also emphasized that while a rupture may not always lead to cancer spreading, the impact on a patient's health can vary and is yet to be determined. (c) 2025 The Authors. Published by Elsevier B.V. on behalf of European Association of Urology. This is an open access article under the CC BY-NC-ND license (http://creative-commons.org/licenses/by-nc-nd/4.0/).ELSEVIER2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=20380European Urology Open ScienceISSN: 26661691ISSNe: 26661683reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p203802026-06-14T12:41:47Z
dc.title.none.fl_str_mv An International Delphi Consensus About Tumor Rupture During Robotic Partial Nephrectomy (Researching UnPredictable TUmor RupturE during Robotic Partial Nephrectomy-The RUPTURE Project)
title An International Delphi Consensus About Tumor Rupture During Robotic Partial Nephrectomy (Researching UnPredictable TUmor RupturE during Robotic Partial Nephrectomy-The RUPTURE Project)
spellingShingle An International Delphi Consensus About Tumor Rupture During Robotic Partial Nephrectomy (Researching UnPredictable TUmor RupturE during Robotic Partial Nephrectomy-The RUPTURE Project)
Bertolo, R
Renal neoplasm
Nephrectomy
Rupture
Delphi
title_short An International Delphi Consensus About Tumor Rupture During Robotic Partial Nephrectomy (Researching UnPredictable TUmor RupturE during Robotic Partial Nephrectomy-The RUPTURE Project)
title_full An International Delphi Consensus About Tumor Rupture During Robotic Partial Nephrectomy (Researching UnPredictable TUmor RupturE during Robotic Partial Nephrectomy-The RUPTURE Project)
title_fullStr An International Delphi Consensus About Tumor Rupture During Robotic Partial Nephrectomy (Researching UnPredictable TUmor RupturE during Robotic Partial Nephrectomy-The RUPTURE Project)
title_full_unstemmed An International Delphi Consensus About Tumor Rupture During Robotic Partial Nephrectomy (Researching UnPredictable TUmor RupturE during Robotic Partial Nephrectomy-The RUPTURE Project)
title_sort An International Delphi Consensus About Tumor Rupture During Robotic Partial Nephrectomy (Researching UnPredictable TUmor RupturE during Robotic Partial Nephrectomy-The RUPTURE Project)
dc.creator.none.fl_str_mv Bertolo, R
Antonelli, A
Bex, A
Anderson, C
Autorino, R
Barber, N
Badani, K
Barod, R
Bensalah, K
Bernhard, JC
Breda, A
Capitanio, U
Challacombe, B
Crivellaro, S
De Groote, R
Derweesh, I
Galfano, A
Harke, N
Kaouk, J
Kutikov, A
Maes, K
Minervini, A
Maresma, MCM
Montorsi, F
Porpiglia, F
Porter, J
Schiavina, R
Siemer, S
Simone, G
Touijer, K
Vaessen, C
Volpe, A
Wu, ZJ
Zondervan, P
Russo, P
Ribal, MJ
Mottrie, A
author Bertolo, R
author_facet Bertolo, R
Antonelli, A
Bex, A
Anderson, C
Autorino, R
Barber, N
Badani, K
Barod, R
Bensalah, K
Bernhard, JC
Breda, A
Capitanio, U
Challacombe, B
Crivellaro, S
De Groote, R
Derweesh, I
Galfano, A
Harke, N
Kaouk, J
Kutikov, A
Maes, K
Minervini, A
Maresma, MCM
Montorsi, F
Porpiglia, F
Porter, J
Schiavina, R
Siemer, S
Simone, G
Touijer, K
Vaessen, C
Volpe, A
Wu, ZJ
Zondervan, P
Russo, P
Ribal, MJ
Mottrie, A
author_role author
author2 Antonelli, A
Bex, A
Anderson, C
Autorino, R
Barber, N
Badani, K
Barod, R
Bensalah, K
Bernhard, JC
Breda, A
Capitanio, U
Challacombe, B
Crivellaro, S
De Groote, R
Derweesh, I
Galfano, A
Harke, N
Kaouk, J
Kutikov, A
Maes, K
Minervini, A
Maresma, MCM
Montorsi, F
Porpiglia, F
Porter, J
Schiavina, R
Siemer, S
Simone, G
Touijer, K
Vaessen, C
Volpe, A
Wu, ZJ
Zondervan, P
Russo, P
Ribal, MJ
Mottrie, A
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Renal neoplasm
Nephrectomy
Rupture
Delphi
topic Renal neoplasm
Nephrectomy
Rupture
Delphi
description Background and objective: Tumor rupture during robot-assisted partial nephrectomy (RAPN) poses oncological risks, including potential malignant cell spread and recurrence. Despite these risks, standardized guidelines for defining, managing, and assessing risk factors of tumor rupture in RAPN are lacking. This Delphi consensus study aimed to frame the definition, risk factors, and oncological implications of tumor rupture in RAPN, as well as to propose management strategies. Methods: Using a modified Delphi method, a steering committee from multiple urological societies (the RUPTURE project) led a consensus-building study that followed the ACcurate COnsensus Reporting Document (ACCORD) checklist. A panel of international experts participated in a two-phase Delphi survey, rating their agreement with statements on tumor rupture, risk factors, and management in RAPN. Consensus was defined as >= 70% agreement, with unresolved statements discussed in an online meeting and subjected to a second voting round. Key findings and limitations: Thirty-three experts evaluated 58 statements. Consensus was reached on 33% of statements in the first round and 37.5% in the second round. Tumor rupture was defined, with risk factors including larger tumor size, complexity, and endophytic growth patterns. Recommended management strategies focused on minimizing tumor spillage by suctioning-rather than grasping-the cancerous tissue, and promptly securing the specimen in an endobag. Routine conversion to radical nephrectomy was not advised unless unresectable tumor remnants were found. Tumor rupture was not linked to distant metastasis, although its oncological impact varied by the rupture extent (ie, gross rupture vs focal; tumor spilled out macroscopically completely removed vs not). Conclusions and clinical implications: This consensus forms a basis for future research on tumor rupture in RAPN, emphasizing standardized definitions and uniform management strategies. Empirical validation through future clinical research is warranted. Patient summary: This research looks at tumor rupture during robotic kidney surgery, which can happen but is rare. The study involved a panel of experts who discussed finding a consensus on when it is more likely to occur and how to manage it effectively to reduce risks. It was also emphasized that while a rupture may not always lead to cancer spreading, the impact on a patient's health can vary and is yet to be determined. (c) 2025 The Authors. Published by Elsevier B.V. on behalf of European Association of Urology. This is an open access article under the CC BY-NC-ND license (http://creative-commons.org/licenses/by-nc-nd/4.0/).
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=20380
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=20380
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER
publisher.none.fl_str_mv ELSEVIER
dc.source.none.fl_str_mv European Urology Open Science
ISSN: 26661691
ISSNe: 26661683
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869407440190046208
score 15,812455

Registos relacionados