Perioperative and Mid-Term Oncological and Functional Outcomes After Partial Nephrectomy for Entirely Endophytic Renal Tumors: A Prospective Multicenter Observational Study (The RECORD2 Project)

This study examines the outcomes of partial nephrectomy for entirely endophytic renal tumors, which are particularly challenging due to their deep location within the kidney. Using data from 211 patients treated at multiple Italian urological centers, the study compared open, laparoscopic, and robotic surgical approaches. The results indicate that while all three methods were effective, robotic partial nephrectomy was associated with lower blood loss, shorter surgery time, and better early kidney function preservation. However, the functional benefits diminished after two years. The study also found that older age and open surgery were independent predictors of worse kidney function recovery. Overall, partial nephrectomy for these tumors was found to be oncologically safe, with a recurrence-free survival rate of 93.8%. The findings suggest that robotic surgery should be preferred when feasible to optimize early kidney function recovery while maintaining good cancer control.