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Updated: Aug 6, 2026
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Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
Experience of Robotic Partial Nephrectomy for Localized Renal Tumors: Functional and Oncologic Outcomes
Tuan Thanh Nguyen1,2, Khac Chuan Hoang2, Trong Tri Tran2
1University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.
World Journal of Oncology
|July 23, 2026
Summary
Robot-assisted partial nephrectomy (RAPN) for larger renal tumors (> 4 cm) shows increased operative time and hospital stay but similar oncologic and functional outcomes compared to smaller tumors (≤ 4 cm). These findings support RAPN feasibility for selected larger malignant renal tumors.
Area of Science:
- Urology
- Surgical Oncology
- Robotic Surgery
Background:
- Limited evidence exists comparing robot-assisted partial nephrectomy (RAPN) outcomes for small versus larger malignant renal tumors.
- Real-world, single-center data on this comparison is particularly scarce.
Purpose of the Study:
- To compare perioperative, renal functional, and oncologic outcomes of RAPN based on tumor size (≤ 4 cm vs. > 4 cm).
- To identify predictors of achieving the trifecta (negative margin, no complications, preserved renal function) after RAPN.
Main Methods:
- Retrospective cohort study of 74 patients undergoing transperitoneal RAPN for malignant renal tumors.
- Patients were divided into two groups: T1a tumors (≤ 4 cm, n=42) and tumors > 4 cm (n=32).
- Outcomes including operative time, warm ischemia time, estimated blood loss, complications, surgical margins, renal function (eGFR), and trifecta achievement were compared. Multivariable logistic regression was used to identify predictors of trifecta achievement.
Main Results:
- Patients with tumors > 4 cm had higher RENAL complexity scores and longer operative times (252.1 vs. 226.3 min) and hospital stays (median 6 vs. 5 days).
- No significant differences were found in warm ischemia time, blood loss, complication rates, positive surgical margins, or trifecta achievement (43.8% vs. 50.0%).
- While absolute eGFR was lower in the > 4 cm group at follow-up, eGFR preservation and CKD upstaging rates did not differ significantly. Tumor size > 4 cm was not an independent predictor of trifecta achievement.
Conclusions:
- RAPN for tumors > 4 cm is associated with increased anatomical complexity and operative burden but comparable oncologic and relative renal functional outcomes to smaller tumors.
- The study supports the feasibility of RAPN for selected larger malignant renal tumors in a real-world setting.
- Comparisons should be interpreted cautiously due to potential underpowering for rare events.
