sPaRT2 – Minimally Invasive Partial versus Radical Nephrectomy for cT2 Renal Cell Carcinoma: A National Matched-Pair Analysis (UroCCR 235)

BACKGROUND: Radical nephrectomy (RN) remains the standard treatment for cT2 renal cell carcinoma (RCC), but partial nephrectomy has emerged as a viable alternative with the development of robot-assisted approaches. However, robust comparative data between robot-assisted partial nephrectomy (RAPN) and RN for large renal tumors remain limited. METHODS: We conducted a multicenter retrospective study using prospectively collected data from the UroCCR network (NCT03293563). Patients undergoing RAPN or minimally invasive RN for cT2M0 RCC were matched 1:1 using propensity scores based on clinical and tumor characteristics. Primary outcome was 5-year disease-free survival (DFS). Secondary endpoints included overall survival (OS), renal function, perioperative outcomes, complications, and Trifecta achievement. RESULTS: ), fewer CKD stage migrations, and reduced acute kidney injury. Major complications were more frequent after RAPN (6% vs. 2%, p = 0.04). The Trifecta outcome was achieved in 46% of RAPN cases. CONCLUSION: RAPN is a safe and functionally superior alternative to RN for selected patients with cT2 RCC. While associated with higher perioperative morbidity, these risks are acceptable in expert centers and offset by long-term nephron-sparing benefits.