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Purpose <p>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).</p> Methods <p>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.</p> Results <p>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 (<i>p</i> = 0.019). Despite a similar rate of postoperative complications, patients undergoing RNU experienced a significantly higher median LOS (<i>p</i> &lt; 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.</p> Conclusions <p>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.</p>

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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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月3日

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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 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

摘要

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.