Comparative Analysis of Trifecta and Pentafecta Outcomes in T1a and T1b Renal Tumors Following Robotic Partial Nephrectomy: A Retrospective Study

Abstract

Purpose: This study aims to conduct a comparative analysis of Trifecta and Pentafecta outcomes between T1a and T1b renal tumors in patients undergoing robotic partial nephrectomy (RAPN). We explore the influence of clinical factors, including the RENAL nephrometry score components, on these outcomes. Methods: A retrospective multicentre study was conducted on 133 patients who underwent RAPN for T1a (n = 51) and T1b (n = 82) renal tumors between 2017 and 2023. We assessed Trifecta and Pentafecta outcomes, and statistical comparisons were made. Univariate and multivariate analyses were conducted to evaluate the impact of tumor size and RENAL components on these outcomes. Results: Trifecta was achieved in 74.5% of T1a tumors and 68.3% of T1b tumors (p = 0.429). Pentafecta outcomes were achieved in 56.9% of T1a and 47.6% of T1b tumors (p = 0.297). Warm ischemia time was significantly longer in T1b tumors (p = 0.037). In the univariate analysis, warm ischemia time and tumor size were significant predictors of Trifecta and Pentafecta outcomes, respectively. Nearness to the collecting system was also a significant factor in univariate analysis (p = 0.045). Other clinical factors such as exophytic/endophytic properties and location relative to polar lines did not significantly impact outcomes. Conclusion: RAPN is equally effective for T1a and T1b renal tumors, providing comparable Trifecta and Pentafecta outcomes. Warm ischemia time, tumor size, and nearness to the collecting system are important factors influencing these outcomes.