The Journal of urology · 2026
sPaRT2-Minimally Invasive Partial vs Radical Nephrectomy for cT2 Renal Cell Carcinoma: A National Matched-Pair Analysis (UroCCR 235).
Сравнительное исследованиеСтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Et-Touzani Rajâa, Bernhard Jean-Christophe, Prudhomme Thomas, Champy Cécile, Waeckel Thibaut, Surlemont Louis, Bourgi Ali, Adypagavane Aravind, Fontenil Alexis, Branger Nicolas, Patard Jean-Jacques, Beauval Jean-Baptiste, Olivier Jonathan, Guillotreau Julien, De Vergie Stéphane, Michel Constance, Vignot Louis, Vallee Maxime, Hoquetis Lionel, Sarrazin Clément, Belas Olivier, Escoffier Agate, Boissier Romain, Taha Fayek, Chatain Vera, Panthier Frédéric, Gaillard Victor, Bigot Pierre, Margue Gaëlle
Аннотация
PURPOSE: Radical nephrectomy (RN) remains the standard treatment for cT2 renal cell carcinoma (RCC), but partial nephrectomy has emerged as a viable alternative with the development of robot-assisted approaches. However, robust comparative data between robot-assisted partial nephrectomy (RAPN) and RN for large renal tumors remain limited.
MATERIALS AND METHODS: We conducted a multicenter retrospective study using prospectively collected data from the UroCCR network (NCT03293563). Patients undergoing RAPN or minimally invasive RN for cT2M0 RCC were matched 1:1 using propensity scores based on clinical and tumor characteristics. Primary outcome was 5-year disease-free survival. Secondary end points included overall survival, renal function, perioperative outcomes, complications, and trifecta achievement.
RESULTS: Of 847 patients included, 250 RAPN and 250 RN were matched. The median tumor size was 8.2 cm in the RN group and 8 cm in the RAPN group. Oncologic outcomes were comparable: 5-year disease-free survival was 61% and 49% (P = .2), cancer-specific survival was 87% and 94% (P = .8), metastasis-free survival was 71% and 66% (P = .4), and overall survival was 80% and 80% (P = .5), for RAPN and RN, respectively. RAPN was associated with improved renal function preservation (median change in estimated glomerular filtration rate at 5 years: -15 vs -23 mL/min/1.73 m2), fewer chronic kidney disease stage migrations, and reduced acute kidney injury. Major complications were more frequent after RAPN (6% vs 2%, P = .04). The trifecta outcome was achieved in 46% of RAPN cases.
CONCLUSIONS: RAPN is a safe and functionally superior alternative to RN for selected patients with cT2 RCC. While associated with higher perioperative morbidity, these risks are acceptable in expert centers and offset by long-term nephron-sparing benefits.
MATERIALS AND METHODS: We conducted a multicenter retrospective study using prospectively collected data from the UroCCR network (NCT03293563). Patients undergoing RAPN or minimally invasive RN for cT2M0 RCC were matched 1:1 using propensity scores based on clinical and tumor characteristics. Primary outcome was 5-year disease-free survival. Secondary end points included overall survival, renal function, perioperative outcomes, complications, and trifecta achievement.
RESULTS: Of 847 patients included, 250 RAPN and 250 RN were matched. The median tumor size was 8.2 cm in the RN group and 8 cm in the RAPN group. Oncologic outcomes were comparable: 5-year disease-free survival was 61% and 49% (P = .2), cancer-specific survival was 87% and 94% (P = .8), metastasis-free survival was 71% and 66% (P = .4), and overall survival was 80% and 80% (P = .5), for RAPN and RN, respectively. RAPN was associated with improved renal function preservation (median change in estimated glomerular filtration rate at 5 years: -15 vs -23 mL/min/1.73 m2), fewer chronic kidney disease stage migrations, and reduced acute kidney injury. Major complications were more frequent after RAPN (6% vs 2%, P = .04). The trifecta outcome was achieved in 46% of RAPN cases.
CONCLUSIONS: RAPN is a safe and functionally superior alternative to RN for selected patients with cT2 RCC. While associated with higher perioperative morbidity, these risks are acceptable in expert centers and offset by long-term nephron-sparing benefits.