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

作者：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, 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 Meagher, Dhruv Puri, Ithaar Derweesh, Farshad Sheybaee Moghaddam, Hooman Djaladat, Riccardo Bertolo, Riccardo Autorino, Alessandro Antonelli · 发表于：World Journal of Urology · 年份：2025 · DOI：10.1007/s00345-025-05882-0 · 被引用次数：4 · 研究领域：Bladder and Urothelial Cancer Treatments、Renal cell carcinoma treatment、Multiple and Secondary Primary Cancers

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...