LAUSR

collected. The newly trifecta included: negative margins, no severe complications, and 30% postoperative eGFR reduction. The ROMe's included no Recurrences, no Overall Mortality and baseline eGFR not significantly reduced (defined as absence of newly onset CKD stage IIIa or IV-V when baseline eGFR was or< 60 mL/min/1.73m). Chi-square and Student-t test were used to compare categorical and continuous variables. Kaplan-Meier method was performed to investigate the predictive role of Trifecta on ROMe's achievement. Survival outcomes were computed at 12, 24, 36, 48, 60 months after surgery and the log-rank test was applied to assess statistical significance between groups. RESULTS: 1434 patients were included (Tab.1). Trifecta was achieved in 1185 (83%) patients. ROMe's was achieved by 1192 (83%) patients: they were significantly younger (p<0.001), thinner (p[0.002), with lower ASA scores (p<0.001), higher baseline eGFR (p<0.001), and less complex tumors (p[0.001). On Kaplan-Meier analysis (Fig.1), Trifecta was significantly associated with a higher probability of achieving the ROMes (p<0.001); in a stratified analysis trifecta was significantly associated with ROMes either when RAPN was performed in elective (p<0.001) or in imperative settings (p<0.046). CONCLUSIONS: ROMes provides a comprehensive summary of long-term outcomes after NSS. Achieving the newly defined Trifectath is a significant predictor of maintaining successful outcomes during follow-up.