Real-World Perioperative and Early Oncological Outcomes of Robot-Assisted Nephroureterectomy for Upper Tract Urothelial Carcinoma: A Single-Institution Series of 100 Consecutive Patients

Abstract

Robot-assisted radical nephroureterectomy (RANU) is increasingly used for upper tract urothelial carcinoma (UTUC), yet most published series are selected and real-world data from consecutive, unselected practice are scarce. We reviewed 100 consecutive RANU performed at a single institution between April 2022 and March 2026, including six cases with a concomitant procedure. Median age was 77 years and 39 patients had pT3–4 disease. Median estimated blood loss was 29 mL, operative time 200 min, and console time 141 min; three patients required transfusion. Clavien–Dindo grade II or higher complications occurred within 90 days in 13 patients, with only one grade III event. At a median follow-up of 15.5 months, the cumulative incidence of intravesical and of distant or local recurrence was approximately 17% and 18% at 12 months, and overall survival was approximately 86% at 24 months. RANU was feasible with favorable perioperative outcomes in this elderly, frequently advanced cohort.