Radical nephroureterectomy vs kidney sparing surgery for upper tract urothelial carcinoma in solitary kidney patients: a multi-institutional analysis of the ROBUUST 2.0 registry Article Swipe

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Francesco Ditonno , Alessandro Veccia , Gabriele Bignante , Zhenjie Wu , Linhui Wang , Firas Abdollah , Alex Stephens , Giuseppe Simone , Gabriele Tuderti , Randall Lee , Daniel Eun , Andres Correa , Ottavio De Cobelli , Matteo Ferro , F. Porpiglia , Daniele Amparore , Enrico Checcucci , Antonio Tufano , Roberto Contieri , Sisto Perdonà , Raj Bhanvadia , Vitaly Margulis , Stephan Brönimann , Nirmish Singla , James Porter , Saum Ghodoussipour , Andrea Minervini , Andrea Mari , Luca Lambertini , Alireza Ghoreifi , Ofer Nativ , Mark L. Gonzalgo , Daniel Sidhom , Chandru P. Sundaram , Reuben Ben‐David , Ahmed Eraky , Reza Mehrazin , Takashi Yoshida , Hidefumi Kinoshita , Alireza Dehghanmanshadi , Soroush Rais‐Bahrami , Margaret Meagher , Dhruv Puri , Ithaar Derweesh , Farshad Sheybaee Moghaddam , Hooman Djaladat , Riccardo Bertolo , Riccardo Autorino , Alessandro Antonelli ·

YOU? · · 2025 · Open Access · · DOI: https://doi.org/10.1007/s00345-025-05882-0

Purpose Radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC) in solitary kidney patients is a rare and underreported scenario. This study aims to compare the outcomes of UTUC solitary kidney patients becoming anephric after RNU to those of patients undergoing kidney-sparing surgery (KSS). Methods Data from patients with a solitary kidney were retrieved from the ROBUUST 2.0 database, a global, multicenter registry containing data on patients who underwent curative surgery for UTUC. Baseline patient demographics, disease characteristics, and surgical features were compared between RNU and KSS. Kaplan-Meier methods were used to estimate recurrence-free survival (RFS), metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival (OS) in patients undergoing RNU, with 3-year and 5-year cutoffs applied. Results Thirty-nine patients (76.5%) underwent RNU, whereas 12 (23.5%) underwent KSS. Despite a comparable preoperative renal function, the distribution of CKD stages differed significantly between the groups ( p = 0.019). Despite a similar rate of postoperative complications, patients undergoing RNU experienced a significantly higher median LOS ( p < 0.001). Among RNU patients, OS was 83.9%, CSS was 96.9%, RFS was 71.8%, and MFS was 84.4% at the 3-year follow-up. After 5 years post-surgery, OS was 73.4%, CSS was 83.1%, RFS was 59.9%, and MFS was 78.5% in the same cohort. Conclusions UTUC solitary kidney patients undergoing RNU or KSS face a substantial perioperative burden. Despite these challenges, our cohort demonstrated favorable oncological outcomes comparable to those reported in the existing literature.

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Medicine Nephrectomy Nephrology Urology Kidney cancer Cohort Renal function Perioperative Kidney disease Kidney Renal cell carcinoma Internal medicine Surgery

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Type: article
Language: en
Landing Page: https://doi.org/10.1007/s00345-025-05882-0
PDF: https://link.springer.com/content/pdf/10.1007/s00345-025-05882-0.pdf
OA Status: hybrid
References: 33
Related Works: 10
OpenAlex ID: https://openalex.org/W4413922980

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DOI: https://doi.org/10.1007/s00345-025-05882-0

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Title: Radical nephroureterectomy vs kidney sparing surgery for upper tract urothelial carcinoma in solitary kidney patients: a multi-institutional analysis of the ROBUUST 2.0 registry

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Publication year: 2025

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Authors: Francesco Ditonno, Alessandro Veccia, Gabriele Bignante, Zhenjie Wu, Linhui Wang, Firas Abdollah, Alex Stephens, Giuseppe Simone, Gabriele Tuderti, Randall Lee, Daniel Eun, Andres Correa, Ottavio De Cobelli, Matteo Ferro, F. Porpiglia, Daniele Amparore, Enrico Checcucci, Antonio Tufano, Roberto Contieri, Sisto Perdonà, Raj Bhanvadia, Vitaly Margulis, Stephan Brönimann, Nirmish Singla, James Porter, Saum Ghodoussipour, Andrea Minervini, Andrea Mari, Luca Lambertini, Alireza Ghoreifi, Ofer Nativ, Mark L. Gonzalgo, Daniel Sidhom, Chandru P. Sundaram, Reuben Ben‐David, Ahmed Eraky, Reza Mehrazin, Takashi Yoshida, Hidefumi Kinoshita, Alireza Dehghanmanshadi, Soroush Rais‐Bahrami, Margaret Meagher, Dhruv Puri, Ithaar Derweesh, Farshad Sheybaee Moghaddam, Hooman Djaladat, Riccardo Bertolo, Riccardo Autorino, Alessandro Antonelli

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Landing page: https://doi.org/10.1007/s00345-025-05882-0

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Concepts: Medicine, Nephrectomy, Nephrology, Urology, Kidney cancer, Cohort, Renal function, Perioperative, Kidney disease, Kidney, Renal cell carcinoma, Internal medicine, Surgery

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