%0 Journal Article
%T Robotic distal ureterectomy for high-risk distal ureteral urothelial carcinoma: a retrospective multicenter comparative analysis (ROBUUST 2.0 collaborative group).
%A Ditonno F
%A Franco A
%A Veccia A
%A Bologna E
%A Wang L
%A Abdollah F
%A Finati M
%A Simone G
%A Tuderti G
%A Helstrom E
%A Correa A
%A DE Cobelli O
%A Ferro M
%A Porpiglia F
%A Amparore D
%A Tufano A
%A Perdonà S
%A Bhanvadia R
%A Margulis V
%A Brönimann A
%A Singla N
%A Puri D
%A Derweesh IH
%A Mendiola DF
%A Gonzalgo ML
%A Ben-David R
%A Mehrazin R
%A Moon SC
%A Rais-Bahrami S
%A Yong C
%A Moghaddam FS
%A Ghoreifi A
%A Sundaram CP
%A Wu Z
%A Djaladat H
%A Antonelli A
%A Autorino R
%J Minerva Urol Nephrol
%V 76
%N 3
%D 2024 Jun
%M 38920013
暂无%R 10.23736/S2724-6051.24.05737-9
%X <B>BACKGROUND: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.