Prospective multi-center study of oncologic outcomes of robot-assisted partial nephrectomy for pT1 renal cell carcinoma

Utilizing prospectively obtained data on RAPN performed by four surgeons at four separate tertiary care centers, we selected patients with unilateral, localized, non-familial, pathologically-confirmed pT1 renal cell carcinoma and a minimum post-operative follow-up of 12 months. Survival analysis (disease-free, cancer-specific, and overall survival) was performed, and Kaplan-Meier curves were generated.RAPN was performed in 124 patients with a median tumor size of 3.0？cm (IQR 2.2-4.2？cm). Median follow-up was 29？months (range 12-46？months). Positive parenchymal surgical margins occurred in two patients (1.6？%), both of whom were recurrence-free at 30 and 34？months after surgery. The three-year Kaplan-Meier estimated disease-free survival was 94.9？%, cancer-specific survival was 99.1？%, and overall survival was 97.3？%.In our cohort of patients with small renal carcinomas who were followed for a median of 29？months, recurrence and survival outcomes were similar to those reported for open and laparoscopic partial nephrectomy. Further long-term outcomes will be needed to definitively claim that RAPN is oncologically equivalent to other surgical approaches.The incidence of small renal neoplasia is increasing, likely secondary to the increasing use of cross-sectional imaging [1]. Although, traditionally, radical nephrectomy has been performed for the definitive treatment of suspected small renal cell cancers, partial nephrectomy has become increasingly popular as a nephron-sparing option [2]. The American Urological Association’s guidelines for management of the clinical T1 renal mass place partial nephrectomy as a standard treatment option [3].Partial nephrectomy may be accomplished via a variety of techniques. Open partial nephrectomy (OPN) has been shown to have excellent long-term oncologic outcomes which are similar to radical nephrectomy [4,5]. Laparoscopic partial nephrectomy (LPN) was developed as a minimally invasive alternative to open partial nephrectomy, and st