Robot-Assisted Partial Nephrectomy Mid-Term Oncologic Outcomes: A Systematic Review

Abstract

Background: Robot-assisted partial nephrectomy (RAPN) is used more and more in present days as a therapy option for surgical treatment of cT1 renal masses. Current guidelines equally recommend open (OPN), laparoscopic (LPN), or robotic partial nephrectomy (PN). The aim of this review was to analyze the most representative RAPN series in terms of reported oncological outcomes. (2) Methods: A systematic search of Webofscience, PUBMED, Clinicaltrials.gov was performed on 1 August 2022. Studies were considered eligible if they: included patients with renal cell carcinoma (RCC) stage T1, were prospective, used randomized clinical trials (RCT) or retrospective studies, had patients undergo RAPN with a minimum follow-up of 48 months. (3) Results: Reported positive surgical margin rates were from 0 to 10.5%. Local recurrence occurred in up to 3.6% of patients. Distant metastases were reported in up to 6.4% of patients. 5-year cancer free survival (CFS) estimates rates ranged from 86.4% to 98.4%. 5-year cancer specific survival (CSS) estimates rates ranged from 90.1% to 100%, and 5-year overall survival (OS) estimates rated ranged from 82.6% to 97.9%. (4) Conclusions: Data coming from retrospective and prospective series shows very good oncologic outcomes after RAPN. Up to now, 10-year survival outcomes were not reported. Taken together, RAPN deliver similar oncologic performance to OPN and LPN.

Outcomes of Open Versus Robotic Partial Nephrectomy: A 20-Year Single Institution Experience

“…This nding persisted on multivariate analysis controlling for T-stage, margin, age, and creatinine at last follow up. Current literature suggests that RPN has similar oncologic outcomes to OPN [13], and no major study has identi ed a major oncologic advantage of RPN compared to OPN. Due to the retrospective and heterogeneous nature of our study, our cancer-speci c ndings may be due to other confounding variables.…”

Current status and challenges of 3D navigation in partial nephrectomy

“…To achieve the goal of preserving renal function in PN, techniques such as the zero-ischemia approach are being researched [4] . As minimally invasive surgical techniques advance, both laparoscopic (LPN) and robot-assisted PN (RAPN) have become increasingly common for treating cT1 and some cT2 renal tumors, with good outcomes reported [5][6][7][8] .…”

Predictive factors for pentafecta achievement in robot‐assisted partial nephrectomy for intermediate highly complex RENAL tumors (RENAL score ≥ 7)

“…Partial nephrectomy (PN) is the standard surgical treatment for localized small renal tumors. Robot‐assisted partial nephrectomy (RAPN) allows for easier techniques, such as tumor resection, suturing, and repair of renal defects, unlike laparoscopic PN 1,2 . RAPN has been used to treat localized cT1 renal tumors.…”

“…Robot-assisted partial nephrectomy (RAPN) allows for easier techniques, such as tumor resection, suturing, and repair of renal defects, unlike laparoscopic PN. 1,2 RAPN has been used to treat localized cT1 renal tumors. Recently, RAPN has been recommended for larger, more complex, and technically challenging tumors.…”