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© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Introduction: Available guidelines recommend performing nephron-sparing surgery in selected renal cell carcinoma (RCC) patients. Many studies provided robot-assisted partial nephrectomy (RAPN) functional and oncological outcomes, with most of these including a wide timespan and a number of surgeons with different experiences, which might lead to the heterogeneity of the results. In this study, we aim to provide a contemporary report of RAPN patient outcomes performed at two referral centers by experienced surgeons. Materials and Methods: Overall, 333 RAPN patients treated at two European referral centers between 2019 and 2021 were identified. Continuous and categorical variables were reported using medians and proportions. Multi-variable logistic regression (MLR) models were fitted to test predictors of off-clamp technique use and trifecta achievement. Results: The median age was 65 (IQR: 57–73) years. The clinical stage distribution was as follows: 224 (67%) cT1a vs. 89 (26%) cT1b vs. 20 cT2 (7%). The median warm ischemia time was 14 (10–18) minutes, with trifecta being achieved in 74% (n = 240) of patients. In MLR models predicting off-clamp surgery, an increasing R.E.N.A.L. score was independently associated with a lower chance of attempting such a technique (OR: 0.69, p-value < 0.001). In models predicting trifecta achievement, both a higher R.E.N.A.L. score (OR: 0.78, p-value = 0.007) and the presence of multiple lesions (OR: 0.29, p-value = 0.007) were independently associated with lower chances of reaching the outcome. Significant upstaging of chronic kidney disease (CKD) stage was recorded in 9.4% of patients after one year of follow-up. Conclusions: We reported the contemporary outcomes of patients treated with RAPN by highly experienced surgeons from two referral centers. This report represents a valid benchmark that could be used for individual patient counseling in the decision-making process.

Details

Title
Contemporary Outcomes of Robot-Assisted Partial Nephrectomy: Results from Two European Referral Institutions
Author
Barletta, Francesco 1 ; Frego Nicola 2 ; de Angelis Mario 1   VIAFID ORCID Logo  ; Resca Stefano 3 ; Ticonosco Marco 3   VIAFID ORCID Logo  ; Vecchio Enrico 4 ; Tamburini, Sara 5 ; Pissavini Alessandro 5   VIAFID ORCID Logo  ; Mourullo, Andrea Noya 6   VIAFID ORCID Logo  ; Kroon, Bin K 7 ; Smits Geert 7 ; Papenburg Bernke 7 ; Lambert, Edward 2 ; D’Hondt Frederick 2 ; De Groote Ruben 2 ; Schatteman, Peter 2 ; Mottrie Alexandre 2 ; De, Naeyer Geert 2 

 Unit of Urology, Division of Oncology, Gianfranco Soldera Prostate Cancer Lab, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; [email protected], Department of Urology, AZORG, 9300 Aalst, Belgium; [email protected] (N.F.); [email protected] (S.R.); [email protected] (M.T.); [email protected] (E.V.); [email protected] (S.T.); [email protected] (A.P.); [email protected] (E.L.); [email protected] (F.D.); [email protected] (R.D.G.); [email protected] (P.S.); [email protected] (A.M.); [email protected] (G.D.N.), ORSI Academy, 9090 Melle, Belgium 
 Department of Urology, AZORG, 9300 Aalst, Belgium; [email protected] (N.F.); [email protected] (S.R.); [email protected] (M.T.); [email protected] (E.V.); [email protected] (S.T.); [email protected] (A.P.); [email protected] (E.L.); [email protected] (F.D.); [email protected] (R.D.G.); [email protected] (P.S.); [email protected] (A.M.); [email protected] (G.D.N.), ORSI Academy, 9090 Melle, Belgium 
 Department of Urology, AZORG, 9300 Aalst, Belgium; [email protected] (N.F.); [email protected] (S.R.); [email protected] (M.T.); [email protected] (E.V.); [email protected] (S.T.); [email protected] (A.P.); [email protected] (E.L.); [email protected] (F.D.); [email protected] (R.D.G.); [email protected] (P.S.); [email protected] (A.M.); [email protected] (G.D.N.), ORSI Academy, 9090 Melle, Belgium, Department of Urology, University of Modena and Reggio Emilia, 41121 Modena, Italy 
 Department of Urology, AZORG, 9300 Aalst, Belgium; [email protected] (N.F.); [email protected] (S.R.); [email protected] (M.T.); [email protected] (E.V.); [email protected] (S.T.); [email protected] (A.P.); [email protected] (E.L.); [email protected] (F.D.); [email protected] (R.D.G.); [email protected] (P.S.); [email protected] (A.M.); [email protected] (G.D.N.), ORSI Academy, 9090 Melle, Belgium, Department of Urology, IRCCS Ospedale Policlinico San Martino, University of Genova, 16132 Genoa, Italy 
 Department of Urology, AZORG, 9300 Aalst, Belgium; [email protected] (N.F.); [email protected] (S.R.); [email protected] (M.T.); [email protected] (E.V.); [email protected] (S.T.); [email protected] (A.P.); [email protected] (E.L.); [email protected] (F.D.); [email protected] (R.D.G.); [email protected] (P.S.); [email protected] (A.M.); [email protected] (G.D.N.), ORSI Academy, 9090 Melle, Belgium, Division of Urology, IRCCS Azienza Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy 
 Department of Urology, AZORG, 9300 Aalst, Belgium; [email protected] (N.F.); [email protected] (S.R.); [email protected] (M.T.); [email protected] (E.V.); [email protected] (S.T.); [email protected] (A.P.); [email protected] (E.L.); [email protected] (F.D.); [email protected] (R.D.G.); [email protected] (P.S.); [email protected] (A.M.); [email protected] (G.D.N.), ORSI Academy, 9090 Melle, Belgium, Department of Urology, Hospitales Universitarios San Roque, 35001 Las Palmas de Gran Canaria, Spain 
 Department of Urology, Rijnstate Hospital, 6815 AD Arnhem, The Netherlands; [email protected] (B.K.K.); [email protected] (G.S.); [email protected] (B.P.) 
First page
2104
Publication year
2025
Publication date
2025
Publisher
MDPI AG
e-ISSN
20726694
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3229141259
Copyright
© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.