{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:30:35Z","timestamp":1787671835509,"version":"build-2736575974"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aims to determine the impact of the number of relevant factors for high\u2010complexity tumors on perioperative outcomes of robot\u2010assisted partial nephrectomy (RAPN).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The 308 patients who underwent RAPN for renal hilar, completely endophytic, or clinical T1b tumors were defined as the complex tumor group (CTG), and the other 752 were defined as the non\u2010complex tumor group (NCTG). The CTG patients were further classified on the basis of their number of relevant factors for high\u2010complexity tumors into the one\u2010factor and multiple\u2010factor subgroups. Perioperative outcomes were compared for each group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median times using the robotic system were 187 and 167\u2009min (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0006), median warm ischemic times (WITs) were 24 and 20\u2009min (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), Grade 3 or higher complication rates were 6.2% and 2.5% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0038), median preserved renal function rates at 1\u2009month postoperatively were 78.9% and 85.2% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), and trifecta achievement rates were 55.2% and 76.9% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), respectively. RFS was significantly worse in CTG than in NCTG (5\u2010year RFS was 92.6% and 97.4%, respectively). In the one\u2010 and multiple\u2010factor subgroups, the median times using the robotic system were 184 and 222\u2009min (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0003), median WITs were 23 and 28\u2009min (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0002), median preserved renal function rates at 1\u2009month postoperatively were 80.1% and 73.1% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0036), and trifecta achievement rates were 59.9% and 37.9% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0014), respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RAPN for high\u2010complexity tumors may show different perioperative outcomes depending on the number of relevant factors. Recurrence appears to be more frequent in high\u2010complexity tumors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70434","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T05:18:58Z","timestamp":1774329538000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Impact of the Relevant Factors as High\u2010Complexity Tumors in Robot\u2010Assisted Partial Nephrectomy"],"prefix":"10.1111","volume":"33","author":[{"given":"Jun","family":"Teishima","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Urology Kobe University, Graduate School of Medicine  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4524-2815","authenticated-orcid":false,"given":"Takuto","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology Kobe University, 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