Practice‐setting and surgeon characteristics heavily influence the decision to perform partial nephrectomy among American Urologic Association surgeons

  title={Practice‐setting and surgeon characteristics heavily influence the decision to perform partial nephrectomy among American Urologic Association surgeons},
  author={Christopher J. Weight and Paul Crispen and Rodney H. Breau and Simon P. Kim and Christine M. Lohse and Stephen A. Boorjian and R. Houston Thompson and Bradley C. Leibovich},
  journal={BJU International},
There is great variability in the utilization of partial nephrectomy, but the causes of these variations are not well understood. The present study underscores the already observed phenomenon of surgical volume influencing surgical planning and outcomes, but it gets at why this might be so. We observe that high‐volume renal surgeons have different thresholds of ‘technical feasibility’. 
Open Partial Nephrectomy
This chapter will provide a detailed discussion of the rationale for PN as well as its current indications, the importance of minimizing renal ischemia and other predictors of postoperative CKD, and the techniques of open PN.
Variability of inter‐observer agreement on feasibility of partial nephrectomy before and after neoadjuvant axitinib for locally advanced renal cell carcinoma (RCC): independent analysis from a phase II trial
To evaluate how many patients could have undergone partial nephrectomy (PN) rather than radical nephrectomy (RN) before and after neoadjuvant axitinib therapy, as assessed by five independent
Association of type of renal surgery and access to robotic technology for kidney cancer: results from a population‐based cohort
To evaluate the relationship between partial nephrectomy and hospital availability of robot‐assisted surgery from a population‐based cohort in the USA, a population-based cohort study is conducted.
Age at diagnosis and the surgical management of small renal carcinomas: findings from a cross‐sectional population‐based study
The use of partial nephrectomy for patients with stage T1a renal cell carcinoma (RCC) by age group (<65 and ≥65 years) in two Australian states is described.
The Adoption of Nephron-Sparing Surgery in Europe - A Trend Analysis in Two Referral Centers from Austria and Germany
Tumor size and year of surgery are independent predictors of PN in this cohort, exemplify the adoption of Pn for RCC in tertiary care centers in Austria and Germany in line with implemented guideline changes.
Surgeon-specific factors affecting treatment decisions among Canadian urologists in the management of pT1a renal tumours.
The results suggest that surgeon age, personal history of cancer, practice-type and other surgeon-specific variables may affect treatments offered among urologists across Canada.
Opposing Views The Management of a Clinical T 1 b Renal Tumor in the Presence of a Normal Contralateral Kidney NEPHRON SPARING SURGERY
For patients with clinical stage T1b tumors, there is little debate that PN yields cancer control outcomes equivalent to those provided by RN, and this conclusion is supported by multiple studies comparing cancer specific survival between these 2 treatments.
Relationship between surgical volume and outcomes in nephron-sparing surgery
The objective is to discuss recent findings on the impact of surgical volume on partial nephrectomy outcomes, and the importance of the surgeon volume remains unclear.
Objectifying Complexity of Kidney Cancers: Relationships of Tumor Anatomy and Outcomes
A standardized classification system to communicate relevant attributes of renal tumors did not exist until recently. The emergence and subsequent validation of the RENAL nephrometry score and soon


Diffusion of surgical innovation among patients with kidney cancer
Despite their potential benefits to patients with kidney cancer, the adoption of partial nephrectomy and laparoscopy has been gradual and asymmetric. To clarify whether this trend reflects
The impact of provider volume on outcomes from urological cancer therapy.
It is found that long-term morbidity associated with radical prostatectomy is significantly associated with individual surgeon volume and there were variations in outcome even among high volume surgeons, suggesting that surgical technique can independently impact outcome.