Robot-assisted nephroureterectomy: surgical and mid-term oncological outcomes in over 1100 patients (ROBUUST 2.0 collaborative group)

IF 3.7 2区医学 Q1 UROLOGY & NEPHROLOGY

BJU International Pub Date : 2024-09-12 DOI:10.1111/bju.16526

Francesco Ditonno, Antonio Franco, Zhenjie Wu, Linhui Wang, Firas Abdollah, Giuseppe Simone, Andres F. Correa, Matteo Ferro, Sisto Perdonà, Daniele Amparore, Raj Bhanvadia, Stephan Brönimann, Dhruv Puri, Dinno F. Mendiola, Reuben Ben-David, Sol C. Moon, Courtney Yong, Farshad S. Moghaddam, Alireza Ghoreifi, Eugenio Bologna, Leslie Claire Licari, Marco Finati, Gabriele Tuderti, Emma Helstrom, Marco Tozzi, Antonio Tufano, Soroush Rais-Bahrami, Chandru P. Sundaram, Reza Mehrazin, Mark L. Gonzalgo, Ithaar H. Derweesh, Francesco Porpiglia, Nirmish Singla, Vitaly Margulis, Alessandro Antonelli, Hooman Djaladat, Riccardo Autorino

{"title":"Robot-assisted nephroureterectomy: surgical and mid-term oncological outcomes in over 1100 patients (ROBUUST 2.0 collaborative group)","authors":"Francesco Ditonno, Antonio Franco, Zhenjie Wu, Linhui Wang, Firas Abdollah, Giuseppe Simone, Andres F. Correa, Matteo Ferro, Sisto Perdonà, Daniele Amparore, Raj Bhanvadia, Stephan Brönimann, Dhruv Puri, Dinno F. Mendiola, Reuben Ben-David, Sol C. Moon, Courtney Yong, Farshad S. Moghaddam, Alireza Ghoreifi, Eugenio Bologna, Leslie Claire Licari, Marco Finati, Gabriele Tuderti, Emma Helstrom, Marco Tozzi, Antonio Tufano, Soroush Rais-Bahrami, Chandru P. Sundaram, Reza Mehrazin, Mark L. Gonzalgo, Ithaar H. Derweesh, Francesco Porpiglia, Nirmish Singla, Vitaly Margulis, Alessandro Antonelli, Hooman Djaladat, Riccardo Autorino","doi":"10.1111/bju.16526","DOIUrl":null,"url":null,"abstract":"<div>\n \n <section>\n \n <h3> Objective</h3>\n \n <p>To analyse surgical, functional, and mid-term oncological outcomes of robot-assisted nephroureterectomy (RANU) in a contemporary large multi-institutional setting.</p>\n </section>\n \n <section>\n \n <h3> Patients and Methods</h3>\n \n <p>Data were retrieved from the ROBotic surgery for Upper tract Urothelial cancer STtudy (ROBUUST) 2.0 database, an international, multicentre registry encompassing data of patients with upper urinary tract urothelial carcinoma undergoing curative surgery between 2015 and 2022. The analysis included all consecutive patients undergoing RANU except those with missing data in predictors. Detailed surgical, pathological, and postoperative functional data were recorded and analysed. Oncological time-to-event outcomes were: recurrence-free survival (RFS), metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival (OS). Survival analysis was performed using the Kaplan–Meier method, with a 3-year cut-off. A multivariable Cox proportional hazard model was built to evaluate predictors of each oncological outcome.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 1118 patients underwent RANU during the study period. The postoperative complications rate was 14.1%; the positive surgical margin rate was 4.7%. A postoperative median (interquartile range) estimated glomerular filtration rate decrease of −13.1 (−27.5 to 0) mL/min/1.73 m<sup>2</sup> from baseline was observed. The 3-year RFS was 59% and the 3-year MFS was 76%, with a 3-year OS and CSS of 76% and 88%, respectively. Significant predictors of worse oncological outcomes were bladder-cuff excision, high-grade tumour, pathological T stage ≥3, and nodal involvement.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>The present study contributes to the growing body of evidence supporting the increasing adoption of RANU. The procedure consistently offers low surgical morbidity and can provide favourable mid-term oncological outcomes, mirroring those of open NU, even in non-organ-confined disease.</p>\n </section>\n </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"134 6","pages":"967-975"},"PeriodicalIF":3.7000,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bju.16526","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BJU International","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/bju.16526","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

To analyse surgical, functional, and mid-term oncological outcomes of robot-assisted nephroureterectomy (RANU) in a contemporary large multi-institutional setting.

Patients and Methods

Data were retrieved from the ROBotic surgery for Upper tract Urothelial cancer STtudy (ROBUUST) 2.0 database, an international, multicentre registry encompassing data of patients with upper urinary tract urothelial carcinoma undergoing curative surgery between 2015 and 2022. The analysis included all consecutive patients undergoing RANU except those with missing data in predictors. Detailed surgical, pathological, and postoperative functional data were recorded and analysed. Oncological time-to-event outcomes were: recurrence-free survival (RFS), metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival (OS). Survival analysis was performed using the Kaplan–Meier method, with a 3-year cut-off. A multivariable Cox proportional hazard model was built to evaluate predictors of each oncological outcome.

Results

A total of 1118 patients underwent RANU during the study period. The postoperative complications rate was 14.1%; the positive surgical margin rate was 4.7%. A postoperative median (interquartile range) estimated glomerular filtration rate decrease of −13.1 (−27.5 to 0) mL/min/1.73 m² from baseline was observed. The 3-year RFS was 59% and the 3-year MFS was 76%, with a 3-year OS and CSS of 76% and 88%, respectively. Significant predictors of worse oncological outcomes were bladder-cuff excision, high-grade tumour, pathological T stage ≥3, and nodal involvement.

Conclusions

The present study contributes to the growing body of evidence supporting the increasing adoption of RANU. The procedure consistently offers low surgical morbidity and can provide favourable mid-term oncological outcomes, mirroring those of open NU, even in non-organ-confined disease.

Abstract Image

查看原文本刊更多论文

机器人辅助肾切除术：1100 多名患者的手术和中期肿瘤治疗效果（ROBUUST 2.0 合作小组）

在当代大型多机构环境中分析机器人辅助肾切除术（RANU）的手术、功能和中期肿瘤治疗效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

BJU International 医学-泌尿学与肾脏学

CiteScore

9.10

自引率

4.40%

发文量

262

审稿时长

1 months

期刊介绍： BJUI is one of the most highly respected medical journals in the world, with a truly international range of published papers and appeal. Every issue gives invaluable practical information in the form of original articles, reviews, comments, surgical education articles, and translational science articles in the field of urology. BJUI employs topical sections, and is in full colour, making it easier to browse or search for something specific.