To describe the practice of robotic-assisted partial nephrectomy (RAPN) in France and prospectively assess the late complications and long-term outcomes.
Prospective, multicenter (n = 16), observational study including all patients diagnosed with a renal tumor who underwent RAPN. Preoperative, intraoperative, postoperative, and follow-up data were collected and stored in the French research network for kidney cancer database (UroCCR). Patients were included over a period of 12 months, then followed for 5 years.
In total, 466 patients were included, representing 472 RAPN. The mean tumor size was 3.4 ± 1.7 cm, most of moderate complexity (median PADUA and RENAL scores of 8 [7-10] and 7 [5-9]). Indication for nephron-sparing surgery was relative in 7.1% of cases and imperative in 11.8%. Intraoperative complications occurred in 6.8% of patients and 4.2% of RAPN had to be converted to open surgery. Severe postoperative complications were experienced in 2.3% of patients and late complications in 48 patients (10.3%), mostly within the first 3 months and mainly comprising vascular, infectious, or parietal complications. At 5 years, 29 patients (6.2%) had chronic kidney disease upstaging, 21 (4.5%) were diagnosed with local recurrence, eight (1.7%) with contralateral recurrence, 25 (5.4%) with metastatic progression, and 10 (2.1%) died of the disease.
Our results reflect the contemporary practice of French expert centers and is, to our knowledge, the first to provide prospective data on late complications associated with RAPN. We have shown that RAPN provides good functional and oncologic outcomes while limiting short- and long-term morbidity.
NCT03292549.
World journal of urology. 2023 Jul 06 [Epub ahead of print]
Gaëlle Margue, Alexandre Ingels, Karim Bensalah, Nicolas Doumerc, Christophe Vaessen, Morgan Roupret, François Audenet, Arnaud Mejean, Franck Bruyere, Jonathan Olivier, Hervé Baumert, Constance Michel, Philippe Paparel, Bastien Parier, Philippe Sebe, Jean-Alexandre Long, Hervé Lang, Thierry Lebret, Jean-Jacques Patard, Jean-Christophe Bernhard
Service d'urologie, Urology Department, Bordeaux University Hospital, CHU de Bordeaux, Place Amelie Raba Leon, 33000, Bordeaux, France. ., Urology Department, Henri Mondor University Hospital, APHP, Paris, France., Urology Department, Rennes University Hospital, Rennes, France., Urology Department, Toulouse University Hospital, Toulouse, France., Urology Department, Pitié-Saplétrière Hospital, APHP, Paris, France., Urology Department, European Georges Pompidou Hospital, Paris, France., Urology Department, Tours University Hospital, Tours, France., Urology Department, Lille University Hospital, Lille, France., Urology Department, Saint Joseph Hospital, Paris, France., Urology Department, Lyon Sud University Hospital, Lyon, France., Urology Department, Bicêtre University Hospital, Le Kremlin-Bicêtre, France., Urology Department, Hospital Group Diaconesses Croix Saint-Simon, Paris, France., Urology Department, Grenoble Alpes University Hospital, Grenoble, France., Urology Department, Strasbourg University Hospital, Strasbourg, France., Urology Department, Foch Hospital, Paris Saclay University, Suresnes, France., Urology Department, Mont de Marsan Hospital, Mont de Marsan, France., Service d'urologie, Urology Department, Bordeaux University Hospital, CHU de Bordeaux, Place Amelie Raba Leon, 33000, Bordeaux, France.