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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2020

01-06-2020 | Nephrectomy | Urologic Oncology

Trends in Renal Tumor Surgery in the United States and Germany Between 2006 and 2014: Organ Preservation Rate Is Improving

Authors: Luka Flegar, Christer Groeben, Rainer Koch, Martin Baunacke, Angelika Borkowetz, Klaus Kraywinkel, Christian Thomas, Johannes Huber

Published in: Annals of Surgical Oncology | Issue 6/2020

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Abstract

Background

Nephron-sparing surgery (NSS) is the treatment of choice for T1 renal tumors. This study compared the implementation of NSS in the United States and Germany.

Methods

Data were derived from the National Inpatient Sample and from the Nationwide German Hospital Billing Database. All cases of NSS and radical nephrectomy from 2006 to 2014 were analyzed. To assess tumor stage distribution, data from the Surveillance, Epidemiology, and End Results database (United States) and from German cancer registries were used.

Results

The study identified 74,663 cases in the United States and 130,051 cases in Germany. The proportion of NSS for T1 tumors increased from 30.6 to 57% in the United States compared with 38.5 to 72.9% (estimation) in Germany (p < 0.001). The proportion of robotic NSS increased from 0 to 54.5% in the United States (p < 0.001) and from 0.2 to 8.6% in Germany (p < 0.001). In a multivariate model, hospitals with higher annual caseloads and a surgical robot favored NSS.

Conclusion

Patients with renal tumors might receive inhomogeneous care based on the resources of the treating institution. The robotic approach is a key driver for better implementation of NSS in the United States, and relevant potential still may exist for more organ preservation.
Appendix
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Metadata
Title
Trends in Renal Tumor Surgery in the United States and Germany Between 2006 and 2014: Organ Preservation Rate Is Improving
Authors
Luka Flegar
Christer Groeben
Rainer Koch
Martin Baunacke
Angelika Borkowetz
Klaus Kraywinkel
Christian Thomas
Johannes Huber
Publication date
01-06-2020
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 6/2020
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-019-08108-x

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