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