There is no evidence from randomized controlled trials comparing robotic-assisted (RAPN) and open partial nephrectomy (OPN). Thus, we performed a phase II randomized controlled trial to compare both approaches. Herein, we report quality of life outcomes until 90 days after surgery.
ROBOCOP II was designed as a single-center, randomized, controlled trial conducted according to the published study protocol. Patients were randomized to undergo either RAPN or OPN in a 1:1 ratio. The quality of life (QoL) questionnaires were completed preoperatively, at hospital discharge, 30 and 90 days postoperatively. QoL questionnaires included the Kidney Disease Quality of Life Short Form (KDQOL-SF), the Quality of Life Questionnaire C30 (EORTC QLQ C30), 5-level version of the EuroQol-5 Dimension questionnaire (EQ-5D-5L) and the Convalescence and Recovery Evaluation (CARE) Score questionnaire.
50 patients underwent surgery. At 90 days postoperatively, there were no significant differences for the KDQOL-SF score (OPN 72.3±19.6 vs. 75.5±15.0, p = 0.850), while there were advantages for RAPN in the subdomains of pain (p=0.006) and physical functioning (0.011) immediately postoperatively. For the EORTC QLQ-C30 there were overall advantages directly after surgery (OPN 62.7±19.8 vs. RAPN 75.1±16.5, p = 0.031), as well as for the subdomains fatigue (p=0.026), pain (p=0.002) and constipation (p=0.045) but no differences at 90 days. No differences were observes for the EQ-5D-5L at 90 days after surgery (OPN 70.0 ±22.0 vs. RAPN 72.4 ±17.3, p=1.000) or at any other time point. Finally, no significant difference were found for the CARE score at 90 days postoperatively (OPN 84.0±13.4 vs. RAPN 85.8 ±10.0, p=0.818) with less pain in the RAPN group (p=0.017) directly after surgery.
There are no differences in QoL 90 days after surgery between RAPN and OPN. However, immediately after surgery, RAPN seems superior in terms of pain, fatigue and physical functioning.