Quality-of-life outcomes of the ROBOtic-assisted versus Conventional Open Partial nephrectomy (ROBOCOP) II trial

Area of Science:

• Urology
• Surgical Oncology
• Quality of Life Research

Background:

• Quality-of-life (QoL) data comparing open partial nephrectomy (OPN) and robot-assisted partial nephrectomy (RAPN) are scarce, particularly from randomized controlled trials (RCTs).
• The ROBOtic-assisted versus Conventional Open Partial nephrectomy (ROBOCOP) II trial was designed to address this gap by comparing QoL outcomes between OPN and RAPN.

Purpose of the Study:

• To comprehensively compare quality-of-life (QoL) outcomes between open partial nephrectomy (OPN) and robot-assisted partial nephrectomy (RAPN).
• To evaluate differences in specific QoL domains, including pain, physical functioning, fatigue, and overall recovery, in the early postoperative period and at 90 days.

Main Methods:

• A single-center, open-label randomized controlled trial (RCT) involving 50 patients undergoing either OPN or RAPN.
• Quality-of-life assessments were conducted using validated questionnaires: Kidney Disease Quality of Life-Short Form, European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire 30-item core, EuroQoL five Dimensions five Levels questionnaire, and Convalescence and Recovery Evaluation questionnaire.
• Data were analyzed descriptively in a modified intention-to-treat population.

Main Results:

• At postoperative Day 90 (POD90), no significant differences in overall QoL scores were observed between OPN and RAPN groups across all questionnaires.
• Immediately after surgery, RAPN demonstrated advantages in the 'Pain' and 'Physical functioning' subdomains of the Kidney Disease Quality of Life-Short Form.
• The European Organisation for Research and Treatment of Cancer quality of life questionnaire 30-item core showed advantages for RAPN directly after surgery in 'Fatigue,' 'Pain,' and 'Constipation' subdomains, with no differences by POD90.

Conclusions:

• Robot-assisted partial nephrectomy (RAPN) offers superior pain management and improved physical functioning in the early postoperative phase compared to open partial nephrectomy (OPN).
• These QoL advantages diminish by 90 days, with both surgical approaches yielding comparable long-term QoL outcomes.
• The findings highlight the transient benefits of RAPN in specific QoL domains during the immediate recovery period.