Oktay ÜÇER, Talha MÜEZZİNOĞLU, Murat GÜLŞEN, Çağrı AKPINAR, Sertaç YAZICI, Serhat ÇETİN, Oğuzcan ERBATU, Volkan İZOL
Bulletin of Urooncology - 2026;25(1):12-17
Objective: Surgical management of renal tumors has shifted toward partial nephrectomy (PN), even in larger or more complex cases. This study aimed to evaluate how clinical practice patterns, surgical approaches, and outcomes of PN evolved over the last decade. Materials and Methods: Using the Turkish Urooncology Association REDCap database, we retrospectively reviewed 3,482 patients who underwent PN for renal cell carcinoma between 1997 and 2024. Patients were stratified into earlier (before 2014) and later (after 2014) groups. Demographic, surgical, perioperative, and oncologic parameters were compared. Subgroup analyses assessed open, laparoscopic, and robot-assisted PN. Statistical analyses were performed using t-tests and chi-square tests with significance set at p<0.05. Results: Patients in the last decade were older (56.9 vs. 54.9 years; p<0.001). Hospital stay, blood loss, and ischemia time were significantly reduced (all p<0.001). The use of minimally invasive PN increased significantly, with robotic procedures comprising 12.2% of cases after 2014 (p<0.001). Intraoperative complications declined from 3.5% to 1.5% (p=0.001), and postoperative complications declined from 14.1% to 6.5% (p<0.001). Recurrence decreased from 8.7% to 3.5% (p<0.001), while positive margin rates remained stable at 9.1% in both groups. Subgroup analyses confirmed reductions in complications and in recurrence for both open and laparoscopic PN. Conclusion: PN has evolved toward wider use in older patients and with minimally invasive techniques. Despite comparable tumor sizes, perioperative complications and recurrence rates declined significantly over time, supporting PN as a safe and effective treatment for complex renal tumors.
