Robot‐assisted partial nephrectomy with minimum follow‐up of 5 years: A multi‐center prospective study in Japan

Objectives Robot‐assisted partial nephrectomy is widely performed for small renal masses, achieving excellent perioperative and intermediate oncological outcomes. However, long‐term oncological, functional, and quality of life outcomes after robot‐assisted partial nephrectomy remain unclear. In this study, we aimed to evaluate quality of life at 1 year and oncological and functional outcomes of robot‐assisted partial nephrectomy after a minimum follow‐up of 5 years. Methods Personal, perioperative, postoperative, functional, oncological, and quality of life data were evaluated. The EQ‐5D‐5L tool, which incorporates health profiles and a EuroQol Visual Analog Scale, was used to assess quality of life preoperatively and 365 days postoperatively. Regarding oncological and functional outcomes, overall survival, recurrence‐free survival, and changes in estimated glomerular filtration rate were calculated. Results There were few changes in levels between the two time points for all EQ‐5D dimensions. The mean change in EQ‐5D‐5L was 0.020 (95% confidence interval 0.006–0.033, P = 0.006), and in EuroQol Visual Analog Scale score 4.60 (95% confidence interval 2.17–7.02, P = 0.0003). Overall and recurrence‐free survival 5 years after robot‐assisted partial nephrectomy were 97.9% and 92.8%, respectively. After an early postoperative decrease, the estimated glomerular filtration rate remained stable over time. Conclusions Robot‐assisted partial nephrectomy in patients with a T1 renal tumor is safe, feasible, and effective from the perspective of quality of life and survival, even after 5 years. When making treatment decisions, perioperative and quality of life outcomes should be considered together with long‐term oncological outcomes.