分析当代大型多机构环境中机器人辅助肾输尿管切除术 (RANU) 的手术、功能和中期肿瘤学结果。数据取自国际上尿路尿路上皮癌 ROBotic 手术 STtudy (ROBUUST) 2.0 数据库，多中心登记包含 2015 年至 2022 年间接受根治性手术的上尿路尿路上皮癌患者的数据。该分析包括所有连续接受 RANU 的患者，除了预测因子数据缺失的患者。记录并分析详细的手术、病理和术后功能数据。肿瘤学时间-事件结果为：无复发生存期（RFS）、无转移生存期（MFS）、癌症特异性生存期（CSS）和总生存期（OS）。使用 Kaplan-Meier 方法进行生存分析，截止时间为 3 年。建立了多变量 Cox 比例风险模型来评估每个肿瘤结果的预测因素。研究期间共有 1118 名患者接受了 RANU。术后并发症发生率为14.1%；手术切缘阳性率为4.7%。观察到术后中位（四分位距）估计肾小球滤过率较基线下降 -13.1 （-27.5 至 0） mL/min/1.73 m2。 3 年 RFS 为 59%，3 年 MFS 为 76%，3 年 OS 和 CSS 分别为 76% 和 88%。较差肿瘤结果的重要预测因素是膀胱套切除、高级别肿瘤、病理T分期≥3和淋巴结受累。本研究为越来越多的证据支持越来越多地采用RANU做出了贡献。该手术始终保持较低的手术发病率，并且可以提供良好的中期肿瘤学结果，与开放式 NU 的效果相似，甚至在非器官局限性疾病中也是如此。© 2024 作者。 BJU International 约翰·威利 (John Wiley) 出版

To analyse surgical, functional, and mid-term oncological outcomes of robot-assisted nephroureterectomy (RANU) in a contemporary large multi-institutional setting.Data were retrieved from the ROBotic surgery for Upper tract Urothelial cancer STtudy (ROBUUST) 2.0 database, an international, multicentre registry encompassing data of patients with upper urinary tract urothelial carcinoma undergoing curative surgery between 2015 and 2022. The analysis included all consecutive patients undergoing RANU except those with missing data in predictors. Detailed surgical, pathological, and postoperative functional data were recorded and analysed. Oncological time-to-event outcomes were: recurrence-free survival (RFS), metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival (OS). Survival analysis was performed using the Kaplan-Meier method, with a 3-year cut-off. A multivariable Cox proportional hazard model was built to evaluate predictors of each oncological outcome.A total of 1118 patients underwent RANU during the study period. The postoperative complications rate was 14.1%; the positive surgical margin rate was 4.7%. A postoperative median (interquartile range) estimated glomerular filtration rate decrease of -13.1 (-27.5 to 0) mL/min/1.73 m2 from baseline was observed. The 3-year RFS was 59% and the 3-year MFS was 76%, with a 3-year OS and CSS of 76% and 88%, respectively. Significant predictors of worse oncological outcomes were bladder-cuff excision, high-grade tumour, pathological T stage ≥3, and nodal involvement.The present study contributes to the growing body of evidence supporting the increasing adoption of RANU. The procedure consistently offers low surgical morbidity and can provide favourable mid-term oncological outcomes, mirroring those of open NU, even in non-organ-confined disease.© 2024 The Author(s). BJU International published by John Wiley & Sons Ltd on behalf of BJU International.