Comparison of open and robotic-assisted partial nephrectomy approaches using multicentric data (UroCCR-47 study).

Area of Science:

• Urology
• Surgical Oncology
• Nephrology

Background:

• Partial nephrectomy is a standard treatment for kidney tumors.
• Comparing robotic-assisted partial nephrectomy (RPN) and open partial nephrectomy (OPN) is crucial for optimizing patient care.
• Contemporary data is needed to evaluate the relative benefits of RPN versus OPN.

Purpose of the Study:

• To compare the peri-operative and functional outcomes of robotic-assisted partial nephrectomy (RPN) and open partial nephrectomy (OPN).
• To assess the impact of RPN versus OPN on post-operative complications, including renal function.
• To evaluate the oncological outcomes of both surgical approaches.

Main Methods:

• Retrospective analysis of a registry including 20 centers from the French Network for Research on Kidney Cancer (UroCCR).
• Data collected from patients who underwent partial nephrectomy between January 2014 and June 2017 (NCT03293563).
• Statistical comparison using adjusted multivariable analyses.

Main Results:

• RPN group (n=1434) showed significantly lower rates of transfusion (2.9% vs 6.0%), surgical revision (2.4% vs 6.7%), and overall post-operative complications (OR 0.48) compared to OPN group (n=571).
• RPN was associated with fewer severe complications (OR 0.29) and shorter hospital stays (34% reduction).
• RPN demonstrated a decreased risk of post-operative acute renal failure and new-onset chronic kidney disease at 3 and 12 months, with no difference in oncological outcomes.

Conclusions:

• Robotic-assisted partial nephrectomy (RPN) is associated with improved peri-operative morbidity and better functional outcomes compared to open partial nephrectomy (OPN).
• RPN leads to shorter hospital stays and reduced risk of post-operative renal complications.
• The findings support the use of RPN for kidney cancer treatment, including large and complex tumors.