Development of Patient-Specific Nomogram for Clinical Decision-Making Between Single-Port versus Multi-Port Robotic Partial Nephrectomy: A Report from the Single Port Advanced Robotic Consortium(SPARC)
Recommended Citation
Soputro N, Okhawere K, Sauer Calvo R, Ramos-Carpinteyro R, Wang Y, Raver M, Snajdar E, Saini I, Chavali JS, Mikesell CD, Pedraza AM, Rogers C, Ahmed M, Stifelman MD, Lorentz A, Autorino R, Yuh B, Nelson RJ, Crivellaro S, Badani KK, Kaouk J. Development of Patient-Specific Nomogram for Clinical Decision-Making Between Single-Port versus Multi-Port Robotic Partial Nephrectomy: A Report from the Single Port Advanced Robotic Consortium(SPARC). J Endourol 2024; 38(S1):A53-A54.
Document Type
Conference Proceeding
Publication Date
8-1-2024
Publication Title
J Endourol
Abstract
Introduction: To develop a patient-specific algorithm to better guide clinical decision-making when considering between Single Port (SP) versus Multi Port (MP) robotic partial nephrectomy (RPN). Methods: A retrospective review was performed on the IRBapproved, prospectively maintained multi-institutional database of the Single Port Advanced Research Consortium (SPARC) to identify all consecutive patients who underwent SP and MP-RPN between 2019 and 2023. Baseline clinicodemographic variables were used to identify the significant predictors of SP-RPN. The significant variables were subsequently used to construct a nomogram to predict the likelihood of SP versus MP-RPN. Results: Of the 1021 patients included in our analysis, 189 (18.5%) and 832 (81.5%) underwent SP and MP- RPN, respectively. Statistically significant predictors of SP-RPN included a lower comorbidity profile, a significant abdominal surgical history as characterized by a higher Hostile Abdomen Index (HAI), as well as lower complexity tumors. The nomogram generated using the aforementioned variables demonstrated a reasonable performance with an Area Under the Curve (AUC) of 0.79. An optimal cutoff point was determined, with likelihood ratios above 0.12 indicating a preference for SP-RPN. Of note, all SP-RPN cases that scored above the 0.12 cutoffexhibited improved perioperative outcomes, including shorter ischemia time and less intraoperative blood loss. Conclusions: Herein, we have devised a novel patient selection algorithm aimed at enhancing clinical decision-making within the expanding repertoire of RPN approaches. The findings highlighted in this study offer valuable guidance to facilitate appropriate patient selection and thereby ensuring favorable perioperative outcomes associated with RPN procedures.
Volume
38
Issue
S1
First Page
A53
Last Page
A54
