Robotic partial nephrectomy to treat large (T2) cystic renal cell carcinoma: a multi-institutional analysis (ROSULA Collaborative Group).

Authors

• Lin Zhao
• Xiaolei Shi
• Fei Guo
• Jiaying Miao
• Chao Zhi
• Guangan Xiao
• Francesco Porpiglia
• Riccardo Autorino
• Umberto Capitanio
• Robert Uzzo
• Chandru Sundaram
• Alexandre Mottrie
• Sisto Perdonà
• Daniel Eun
• Jihad Kaouk
• Giuseppe Simone
• Ithaar H Derweesh
• Linhui Wang
• Bo Yang
• Chao Zhang

Publication/Presentation Date

1-1-2026

Abstract

PURPOSE: To investigate the feasibility and safety of robot-assisted partial nephrectomy (RAPN) to treat large (T2) cystic renal-cell carcinoma.

METHODS: A multinational study was conducted worldwide. Patients with renal tumors larger than 7cm who underwent partial nephrectomy between December 2007 and July 2017 were recruited retrospectively. The patients were divided into solid tumor group (143 cases) and cystic tumor group (28 cases). Baseline parameters, tumor characteristics, perioperative variables, and pathological outcomes were collected.

RESULTS: Between cystic and solid tumors, no statistically significant differences were detected in age, gender, BMI, ASA score, clinical tumor size, laterality, or R.E.N.A.L nephrometry score. Operating time, warm ischemic time, estimated blood loss, complications, histology outcomes, and margin status were comparable. Pathology of 6 cystic tumors came back benign (21.4%). In solid tumors, 6 intraoperative bleeding require transfusion, 1 ureteral damage, and 3 postoperative urinary fistulas were observed. In cystic tumors, conversion to radical nephrectomy happened in one case, because of sticky fat and the risk of cyst rupture. In two cases, postoperative bleeding was treated with embolism. The longest follow-up was 113 months. In cystic group, 1 recurrence or metastasis was observed, while in solid group, 14 cases were observed.

CONCLUSION: RAPN can be safely performed to treat large (T2) cystic renal-cell carcinoma. Patients with cystic renal-cell carcinoma exhibited favorable renal function recovery after robot-assisted partial nephrectomy (RAPN), which maximally preserved normal renal tissue and its function. Further studies are needed to better understand the role of RAPN for these challenging cases.

Volume

58

Issue

1

First Page

25

Last Page

31

ISSN

1573-2584

Published In/Presented At

Zhao, L., Shi, X., Guo, F., Miao, J., Zhi, C., Xiao, G., Porpiglia, F., Autorino, R., Capitanio, U., Uzzo, R., Sundaram, C., Mottrie, A., Perdonà, S., Eun, D., Kaouk, J., Simone, G., Derweesh, I. H., Wang, L., Yang, B., & Zhang, C. (2026). Robotic partial nephrectomy to treat large (T2) cystic renal cell carcinoma: a multi-institutional analysis (ROSULA Collaborative Group). International urology and nephrology, 58(1), 25–31. https://doi.org/10.1007/s11255-025-04604-0

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

40542967

Department(s)

Administration and Leadership

Document Type

Article