KEY TAKEAWAYS
- The study aimed to compare outcomes of RPN and OPN for RCC, analyzing procedural and oncologic outcomes over 20 years.
- Researchers noticed RPN offers better outcomes and shorter ischemia times than OPN, but treatment optimization is needed.
Robotic-assisted partial nephrectomy (RPN) for renal cell carcinoma (RCC) has become popular for treating appropriately sized renal masses in urologic practice.
Harrison Love and the team aimed to compare the outcomes of robotic assisted partial nephrectomy(RPN) and open partial nephrectomy (OPN) for RCC over 20 years, focusing on demographics, procedural details, and oncologic outcomes such as recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS).
Researchers conducted a retrospective study of patients with RCC who underwent either RPN or OPN from 2000 to 2022 at a single institution. Data collected included patient demographics and procedural details such as ischemia and operative time. Kaplan-Meier statistics analyzed oncologic outcomes to evaluate RFS, CSS, and OS.
The results included 849 patients with RPN and 385 who had OPN, with 61% male and an average age of 58.8 years. Operative time was shorter for OPN (184 minutes) compared to RPN (200 minutes, P=0.002), and ischemia time was also shorter for OPN (16 minutes) compared to RPN (19 minutes, P=0.047).
After 2012, RPN became more common, shoring improved ischemia times. After adjusting for
T-stage and margin status, RPN was associated with significantly better RFS (HR 0.45, P=0.0004) and OS (HR 0.51, P=0.0016). More pT1 masses were treated with OPN (11.2%) compared to RPN (5.4%, P<0.0001).
The study concluded that RPN usage increased with shorter ischemia times than OPN. Despite higher-stage renal masses being more commonly managed with OPN, RPN provides superior oncologic outcomes. Further research is needed to refine the selection criteria for RPN versus OPN.
Authors have not disclosed any funding.
Source: https://pubmed.ncbi.nlm.nih.gov/39115647/
Love H, Yong C, Slaven JE, et al. (2024). “Outcomes of open versus robotic partial nephrectomy: a 20-year single institution experience.” J Robot Surg. 2024 Aug 8;18(1):315. doi: 10.1007/s11701-024-02027-0. PMID: 39115647.
