Long-Term Functional and Oncologic Outcomes Following Robotic Partial and Radical Nephrectomy: A Report from a Single Institution with up to 15 Years of Follow-up.

OBJECTIVE: To evaluate the long-term functional and oncological outcomes following robotic partial (RAPN) and radical nephrectomy (RARN).

MATERIALS AND METHODS: A retrospective review was performed on 1816 patients who underwent RAPN and RARN at our institution between January 2006 and January 2018. Patients with long-term follow-ups of at least 5 years were selected. Exclusion criteria included patients with a previous history of partial or radical nephrectomy, known genetic mutations, and whose procedures were performed for benign indications Statistical analysis was performed with results as presented.

RESULTS: A total of 769 and 142 patients who underwent RAPN and RARN met our inclusion criteria. The duration of follow-up was similar after the two procedures with a median of nearly 100 months. The 5- and 10-year chronic kidney disease (CKD) upstaging-free survivals were 74.5% and 65.9% following RAPN and 53% and 46.4% after RARN, respectively. Older age was identified as a potential predictor for CKD progression after RARN, while older age, higher BMI, baseline renal function, and ischemia time were shown to predict CKD progression following RAPN. RCC-related mortality rates for RAPN and RARN were equally 1.1%. No statistically significant differences were identified in the local recurrence, metastatic, and disease-specific survival between the two procedures.

CONCLUSION: Compared to RARN, RAPN conferred a better CKD progression-free survival. Several factors were identified as potential predictors for clinically significant CKD progression both in the early and late postoperative phase. Long-term oncological outcomes between the two procedures remained similarly favorable.