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Robotic distal ureterectomy for high-risk distal ureteral urothelial carcinoma: a retrospective multicenter comparative analysis (ROBUUST 2.0 collaborative group).
Ditonno, Francesco; Franco, Antonio; Veccia, Alessandro; Bologna, Eugenio; Wang, Linhui; Abdollah, Firas; Finati, Marco; Simone, Giuseppe; Tuderti, Gabriele; Helstrom, Emma; Correa, Andreas; DE Cobelli, Ottavio; Ferro, Matteo; Porpiglia, Francesco; Amparore, Daniele; Tufano, Antonio; Perdonà, Sisto; Bhanvadia, Raj; Margulis, Vitaly; Brönimann, Andres; Singla, Nirmish; Puri, Dhruv; Derweesh, Ithaar H; Mendiola, Dinno F; Gonzalgo, Mark L; Ben-David, Reuben; Mehrazin, Reza; Moon, Sol C; Rais-Bahrami, Soroush; Yong, Courtney; Moghaddam, Farshad Sheybaee; Ghoreifi, Alireza; Sundaram, Chandru P; Wu, Zhenjie; Djaladat, Hooman; Antonelli, Alessandro; Autorino, Riccardo.
Affiliation
  • Ditonno F; Department of Urology, Rush University, Chicago, IL, USA.
  • Franco A; Department of Urology, University of Verona, Verona, Italy.
  • Veccia A; Department of Urology, Rush University, Chicago, IL, USA.
  • Bologna E; Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
  • Wang L; Department of Urology, University of Verona, Verona, Italy.
  • Abdollah F; Department of Urology, Rush University, Chicago, IL, USA.
  • Finati M; Department of Maternal-Child and Urological Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy.
  • Simone G; Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China.
  • Tuderti G; Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA.
  • Helstrom E; Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA.
  • Correa A; Department of Urology, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
  • DE Cobelli O; Department of Urology, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
  • Ferro M; Fox Chase Cancer Center, Philadelphia, PA, USA.
  • Porpiglia F; Fox Chase Cancer Center, Philadelphia, PA, USA.
  • Amparore D; Division of Urology, European Institute of Oncology (IEO)-IRCCS, Milan, Italy.
  • Tufano A; Division of Urology, European Institute of Oncology (IEO)-IRCCS, Milan, Italy.
  • Perdonà S; Division of Urology, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy.
  • Bhanvadia R; Division of Urology, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy.
  • Margulis V; Istituto Nazionale Tumori (INT), IRCCS G. Pascale Foundation, Naples, Italy.
  • Brönimann A; Istituto Nazionale Tumori (INT), IRCCS G. Pascale Foundation, Naples, Italy.
  • Singla N; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
  • Puri D; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
  • Derweesh IH; School of Medicine, Brady Urological Institute, Johns Hopkins Medicine, Baltimore, MD, USA.
  • Mendiola DF; School of Medicine, Brady Urological Institute, Johns Hopkins Medicine, Baltimore, MD, USA.
  • Gonzalgo ML; UC San Diego School of Medicine, Department of Urology, La Jolla, CA, USA.
  • Ben-David R; UC San Diego School of Medicine, Department of Urology, La Jolla, CA, USA.
  • Mehrazin R; Miller School of Medicine, Desai Sethi Urology Institute, University of Miami, Miami, FL, USA.
  • Moon SC; Miller School of Medicine, Desai Sethi Urology Institute, University of Miami, Miami, FL, USA.
  • Rais-Bahrami S; Icahn School of Medicine, Department of Urology, Mount Sinai Hospital, New York, NY, USA.
  • Yong C; Icahn School of Medicine, Department of Urology, Mount Sinai Hospital, New York, NY, USA.
  • Moghaddam FS; Heersink School of Medicine, Department of Urology, University of Alabama at Birmingham, Birmingham, AL, USA.
  • Ghoreifi A; Heersink School of Medicine, Department of Urology, University of Alabama at Birmingham, Birmingham, AL, USA.
  • Sundaram CP; Department of Urology, Indiana University, Indianapolis, IN, USA.
  • Wu Z; Norris Comprehensive Cancer Center, Institute of Urology, University of Southern California, Los Angeles, CA, USA.
  • Djaladat H; Norris Comprehensive Cancer Center, Institute of Urology, University of Southern California, Los Angeles, CA, USA.
  • Antonelli A; Department of Urology, Indiana University, Indianapolis, IN, USA.
  • Autorino R; Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China.
Minerva Urol Nephrol ; 76(3): 331-339, 2024 Jun.
Article in En | MEDLINE | ID: mdl-38920013
ABSTRACT

BACKGROUND:

The role of kidney-sparing surgery in patients with high-risk upper urinary tract urothelial carcinoma is controversial. The present study aimed to assess oncological and functional outcomes of robot-assisted distal ureterectomy in patients with high-risk distal ureteral tumors.

METHODS:

The ROBUUST 2.0 multicenter international (2015-2022) dataset was used for this retrospective cohort analysis. High-risk patients with distal ureteral tumors were divided based on type of surgery robot-assisted distal ureterectomy or robot-assisted nephroureterectomy. A survival analysis was performed for local recurrence-free survival, distant metastasis-free survival, and overall survival. After adjusting for clinical features of the high-risk prognostic group, Cox proportional hazard model was plotted to evaluate significant predictors of time-to-event outcomes.

RESULTS:

Overall, 477 patients were retrieved, of which 58 received robot-assisted distal ureterectomy and 419 robot-assisted nephroureterectomy, respectively, with a mean (±SD) follow-up of 29.6 months (±2.6). The two groups were comparable in terms of baseline features. At survival analysis, no significant difference was observed in terms of recurrence-free survival (P=0.6), metastasis-free survival (P=0.5) and overall survival (P=0.7) between robot-assisted distal ureterectomy and robot-assisted nephroureterectomy. At Cox regression analysis, type of surgery was never a significant predictor of worse oncological outcomes. At last follow-up patients undergoing robot-assisted distal ureterectomy had significantly better postoperative renal function.

CONCLUSIONS:

Comparable outcomes in terms of recurrence-free survival, metastasis-free survival, and overall survival between robot-assisted distal ureterectomy and robot-assisted nephroureterectomy patients, and better postoperative renal function preservation in the former group were observed. Kidney-sparing surgery should be considered as a potential option for selected patients with high-risk distal ureteral UTUC.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Ureter / Ureteral Neoplasms / Carcinoma, Transitional Cell / Robotic Surgical Procedures / Nephroureterectomy Limits: Aged / Female / Humans / Male / Middle aged Language: En Journal: Minerva Urol Nephrol Year: 2024 Type: Article Affiliation country: United States
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Ureter / Ureteral Neoplasms / Carcinoma, Transitional Cell / Robotic Surgical Procedures / Nephroureterectomy Limits: Aged / Female / Humans / Male / Middle aged Language: En Journal: Minerva Urol Nephrol Year: 2024 Type: Article Affiliation country: United States