Pd20-04 Robotic Distal Ureterectomy for High-Risk Distal Ureteral Urothelial Carcinoma: A Retrospective Multicenter Comparative Analysis (Robuust Collaborative Analysis)

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma I (PD20)1 May 2024PD20-04 ROBOTIC DISTAL URETERECTOMY FOR HIGH-RISK DISTAL URETERAL UROTHELIAL CARCINOMA: A RETROSPECTIVE MULTICENTER COMPARATIVE ANALYSIS (ROBUUST COLLABORATIVE ANALYSIS) Francesco Ditonno, Antonio Franco, Celeste Manfredi, Zhenjie Wu, Linhui Wang, Firas Abdollah, Marco Finati, Giuseppe Simone, Gabriele Tuderti, Emma Helstrom, Andreas Correa, Ottavio De Cobelli, Matteo Ferro, Francesco Porpiglia, Daniele Amparore, Antonio Tufano, Sisto Perdonà, Raj Bhanvadia, Vitaly Margulis, Stephan Bronimann, Nirmish Singla, Dhruv Puri, Ithaar H. Derweesh, Dinno F. Mendiola, Eugenio Bologna, Leslie Claire Licari, Mark L. Gonzalgo, Reuben Ben David, Reza Mehrazin, Sol C. Moon, Soroush Rais-Bahrami, Courtney Young, Chandru P. Sundaram, Farshad Sheybaee Moghaddam, Alireza Ghoreifi, Hooman Djaladat, Alessandro Antonelli, and Riccardo Autorino Francesco DitonnoFrancesco Ditonno , Antonio FrancoAntonio Franco , Celeste ManfrediCeleste Manfredi , Zhenjie WuZhenjie Wu , Linhui WangLinhui Wang , Firas AbdollahFiras Abdollah , Marco FinatiMarco Finati , Giuseppe SimoneGiuseppe Simone , Gabriele TudertiGabriele Tuderti , Emma HelstromEmma Helstrom , Andreas CorreaAndreas Correa , Ottavio De CobelliOttavio De Cobelli , Matteo FerroMatteo Ferro , Francesco PorpigliaFrancesco Porpiglia , Daniele AmparoreDaniele Amparore , Antonio TufanoAntonio Tufano , Sisto PerdonàSisto Perdonà , Raj BhanvadiaRaj Bhanvadia , Vitaly MargulisVitaly Margulis , Stephan BronimannStephan Bronimann , Nirmish SinglaNirmish Singla , Dhruv PuriDhruv Puri , Ithaar H. DerweeshIthaar H. Derweesh , Dinno F. MendiolaDinno F. Mendiola , Eugenio BolognaEugenio Bologna , Leslie Claire LicariLeslie Claire Licari , Mark L. GonzalgoMark L. Gonzalgo , Reuben Ben DavidReuben Ben David , Reza MehrazinReza Mehrazin , Sol C. MoonSol C. Moon , Soroush Rais-BahramiSoroush Rais-Bahrami , Courtney YoungCourtney Young , Chandru P. SundaramChandru P. Sundaram , Farshad Sheybaee MoghaddamFarshad Sheybaee Moghaddam , Alireza GhoreifiAlireza Ghoreifi , Hooman DjaladatHooman Djaladat , Alessandro AntonelliAlessandro Antonelli , and Riccardo AutorinoRiccardo Autorino View All Author Informationhttps://doi.org/10.1097/01.JU.0001009556.54476.eb.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: 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 distal ureterectomy in patients with high-risk distal ureteral tumors. METHODS: The ROBUUST (ROBotic surgery for Upper Tract Urothelial Cancer Study) multicenter international (2015-2022) dataset was used for this retrospective cohort analysis. After identifying high-risk patients with tumors of the distal ureter, the study population was divided into two subgroups according to surgical procedure, robot-assisted distal ureterectomy (RADU) or robot-assisted nephroureterectomy (RANU). A survival analysis of the primary endpoint recurrence-free survival (RFS) was performed. Secondary endpoints were metastasis-free survival (MFS) and overall survival (OS). 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. RESULTS: Overall, 477 patients with distal ureteral high-risk UTUC were retrieved, of which 58 received RADU and 419 RANU, respectively, with a mean (±SD) follow-up of 29.6 months (±2.6). No significant difference in terms of baseline features was observed between the two groups. Mean (±SD) tumor size was significantly higher in the RANU group (2.9±2 vs 2.3±1.6, p=0.03), even though no difference was observed in the proportion of lesions of≥2 cm (66.1% vs 58.5%, p=0.3). A comparable number of patients had cT≥2 (12.4% vs 8.6%, p=0.4) tumors. At survival analysis a RFS of 8.2 months (±2.6) and 9.3 months (±4) was observed for RADU and RANU, respectively, with no significant difference between the treatment modalities (p=0.6). The two cohorts were comparable also in terms of MFS (p=0.5) and OS (p=0.7). At Cox regression analysis, in each model for the different time-to-event outcomes, the type of surgery was never a significant predictor of worse oncological outcomes. At last follow-up patients undergoing RADU had significantly better post-operative renal function in terms of mean (±SD) eGFR (60.7±2.4 vs 52.3±4.9, p=0.01). CONCLUSIONS: Our findings suggest comparable outcomes in terms of RFS, MFS and OS between RADU and RANU patients, 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. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e447 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Francesco Ditonno More articles by this author Antonio Franco More articles by this author Celeste Manfredi More articles by this author Zhenjie Wu More articles by this author Linhui Wang More articles by this author Firas Abdollah More articles by this author Marco Finati More articles by this author Giuseppe Simone More articles by this author Gabriele Tuderti More articles by this author Emma Helstrom More articles by this author Andreas Correa More articles by this author Ottavio De Cobelli More articles by this author Matteo Ferro More articles by this author Francesco Porpiglia More articles by this author Daniele Amparore More articles by this author Antonio Tufano More articles by this author Sisto Perdonà More articles by this author Raj Bhanvadia More articles by this author Vitaly Margulis More articles by this author Stephan Bronimann More articles by this author Nirmish Singla More articles by this author Dhruv Puri More articles by this author Ithaar H. Derweesh More articles by this author Dinno F. Mendiola More articles by this author Eugenio Bologna More articles by this author Leslie Claire Licari More articles by this author Mark L. Gonzalgo More articles by this author Reuben Ben David More articles by this author Reza Mehrazin More articles by this author Sol C. Moon More articles by this author Soroush Rais-Bahrami More articles by this author Courtney Young More articles by this author Chandru P. Sundaram More articles by this author Farshad Sheybaee Moghaddam More articles by this author Alireza Ghoreifi More articles by this author Hooman Djaladat More articles by this author Alessandro Antonelli More articles by this author Riccardo Autorino More articles by this author Expand All Advertisement PDF downloadLoading ...