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 - Summary - MDSpire

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

  • By

  • Francesco Ditonno

  • Alessandro Veccia

  • Gabriele Bignante

  • Zhenjie Wu

  • Linhui Wang

  • Firas Abdollah

  • Alex Stephens

  • Giuseppe Simone

  • Gabriele Tuderti

  • Randall Lee

  • Daniel D. Eun

  • Andres F. Correa

  • Ottavio De Cobelli

  • Matteo Ferro

  • Francesco 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

  • Omri Falik 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 F. Meagher

  • Dhruv Puri

  • Ithaar H. Derweesh

  • Farshad S. Moghaddam

  • Hooman Djaladat

  • Riccardo Bertolo

  • Riccardo Autorino

  • Alessandro Antonelli

  • September 3, 2025

  • 0 min

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Objective:

To compare outcomes of radical nephroureterectomy (RNU) and kidney sparing surgery (KSS) in patients with solitary kidneys diagnosed with upper tract urothelial carcinoma (UTUC), highlighting the clinical significance of this comparison.

Key Findings:
  • Out of 3,216 patients, 51 had a solitary kidney; 39 underwent RNU and 12 KSS, with implications of age differences on treatment outcomes.
  • Patients undergoing RNU were significantly older (median age 80) compared to those undergoing KSS (median age 70), which may affect postoperative recovery.
  • Median operative time and estimated blood loss were higher for RNU compared to KSS, indicating a need for careful surgical planning.
  • Length of stay was significantly longer for RNU (7.5 days) than for KSS (3 days), suggesting a potential benefit of KSS in recovery time.
  • Postoperative complications were similar between RNU and KSS groups, highlighting the safety of KSS.
Interpretation:

KSS is a viable option for solitary kidney patients with UTUC, showing comparable outcomes to RNU, particularly in younger patients with lower CKD stages, but potential risks in older patients should be considered.

Limitations:
  • Small sample size of solitary kidney patients limits generalizability and may affect statistical power.
  • Data on long-term oncological outcomes and renal function post-surgery were limited, necessitating further investigation.
Conclusion:

KSS may offer a favorable balance between oncological control and renal preservation in solitary kidney patients with UTUC, but further studies are needed to validate these findings and confirm the safety and efficacy of KSS in diverse patient populations.

Original Source(s)

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

  • by Francesco Ditonno, Alessandro Veccia, Gabriele Bignante, Zhenjie Wu, Linhui Wang, Firas Abdollah, Alex Stephens, Giuseppe Simone, Gabriele Tuderti, Randall Lee, Daniel D. Eun, Andres F. Correa, Ottavio De Cobelli, Matteo Ferro, Francesco 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, Omri Falik 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 F. Meagher, Dhruv Puri, Ithaar H. Derweesh, Farshad S. Moghaddam, Hooman Djaladat, Riccardo Bertolo, Riccardo Autorino, Alessandro Antonelli

  • September 3, 2025

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