Robotic Distal Ureterectomy for High-Risk Distal Ureteral Urothelial Carcinoma: A Retrospective Multicenter Comparative Analysis (ROBUUST Collaborative Analysis)
Recommended Citation
Ditonno F, Pandolfo SD, Franco A, Derweesh IH, Margulis V, Abdollah F, Ferro M, Djaladat H, Guruli G, Simone G, Mehrazin R, Gonzalgo ML, Wu Z, Porpiglia F, Eun DD, Correas A, Minervini A, Sundaram CP, Autorino R. Robotic Distal Ureterectomy for High-Risk Distal Ureteral Urothelial Carcinoma: A Retrospective Multicenter Comparative Analysis (ROBUUST Collaborative Analysis). J Endourol 2023; 37:A89-A90.
Document Type
Conference Proceeding
Publication Date
9-1-2023
Publication Title
J Endourol
Abstract
Introduction: The role of kidney-sparing surgery (KSS) in patients with high-risk upper urinary tract urothelial carcinoma (UTUC) is controversial. The aim of this study was to assess the outcomes of robotic distal ureterectomy in patients with highrisk distal ureteral tumours. Methods: Three hundred and sixty-five patients with high-risk UTUC of the distal ureter were retrieved from the ROBUUST (ROBotic surgery for Upper Tract Urothelial Cancer Study) multicenter international (2006- 2019). The study population was divided in two subgroups according to the type of surgical approach: 38 patients treated with robotic distal ureterectomy and 135 treated with robotic nephroureterectomy (RNU). Time to recurrence, defined by urinary cytology, CT scan or cystoscopy at last follow-up, was the primary endpoint. Secondary endpoint was the post-operative renal function, calculated as eGFR at last follow- up. A Mann-Whitney U test was performed to compare mean (± SD) of each outcome between the two populations. Results: In the overall population, mean age was 70.4 years (±9.3), with a mean preoperative Cr of 1.2 (±0.8) mg/dL and a mean tumour size of 3.3 (±2.1) cm. No significant difference was observed in terms of time to recurrence (13.3 months vs 14.3 months, p = 0.8) between patients treated with distal ureterectomy and RNU. Post-operative eGFR, instead, was significantly better in patients treated with distal ureterectomy (63.4 mL/min/1.73m2vs 51 mL/min/1.73m2,p = 0.01). Conclusions: Within the limitations related to the retrospective study design, our findings suggest comparable outcomes in terms of time to recurrence between distal ureterectomy and RNU, and an advantage of in terms of post-operative renal function preservation. KSS might be considered as a potential option for selected high-risk patients.
Volume
37
First Page
A89
Last Page
A90
