MP42-16 IMPACT OF PRE-EXSISTING DIABETES MELLITUS ON SURVIVAL IN STAGE I RENAL CELL CARCINOMA (2018)

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV1 Apr 2018MP42-16 IMPACT OF PRE-EXSISTING DIABETES MELLITUS ON SURVIVAL IN STAGE I RENAL CELL CARCINOMA Stephen Ryan, Ahmet Bindayi, Robert Uzzo, Aaron Bloch, Madhumitha Reddy, Zachary Hamilton, Ryan Nasseri, Kendrick Yim, Fang Wan, Umberto Capitanio, Alessandro Larcher, Francesco Montorsi, Sabrina Noyes, Sumi Dey, Shreyas Joshi, Brian Lane, and Ithaar Derweesh Stephen RyanStephen Ryan More articles by this author , Ahmet BindayiAhmet Bindayi More articles by this author , Robert UzzoRobert Uzzo More articles by this author , Aaron BlochAaron Bloch More articles by this author , Madhumitha ReddyMadhumitha Reddy More articles by this author , Zachary HamiltonZachary Hamilton More articles by this author , Ryan NasseriRyan Nasseri More articles by this author , Kendrick YimKendrick Yim More articles by this author , Fang WanFang Wan More articles by this author , Umberto CapitanioUmberto Capitanio More articles by this author , Alessandro LarcherAlessandro Larcher More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , Sabrina NoyesSabrina Noyes More articles by this author , Sumi DeySumi Dey More articles by this author , Shreyas JoshiShreyas Joshi More articles by this author , Brian LaneBrian Lane More articles by this author , and Ithaar DerweeshIthaar Derweesh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1323AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES AUA guidelines recommend consideration of nephron sparing surgery in patients with comorbidities that are likely to impact renal function, such as diabetes mellitus (DM). We compared the impact of partial nephrectomy (PN) and radical nephrectomy (RN) on overall survival (OS) in patients with pre-existing DM and Stage I Renal Cell Carcinoma (RCC). METHODS Multicenter retrospective analysis of surgically treated Stage I RCC from 2005-16 with or without DM. Primary outcome was OS analyzed by DM+ or DM- and surgical approach (PN or RN) for AJCC Stage I. Kaplan-Meier analysis (KMA), Logistic (OR) and Cox (HR) regression were utilized for OS. RESULTS 2173 patients were analyzed (1223 RN, 1819 PN, 555 DM+, 2487 DM-) with mean follow-up of 49.1 months. Increasing Age (OR 1.028, p=.009), RN (OR 2.446, p=.001), and most recent eGFR<45 (OR 2.306 p=.002) remained significant on multivariate analysis for OS (Table 1). In the PN subgroup, DM+ or DM- was not associated with decreased OS (HR 1.48 p=0.19). DM+ was associated with decreased OS in the RN subgroup (HR 1.97 p=0.005). Log Rank on KMA for PN (Fig1 p=0.183), and RN (Fig2 p=0.004) for DM+ versus DM-. CONCLUSIONS In Stage I RCC, DM and RN negatively impacted OS, while only RN remained significant on MVA. Subgroup analysis of PN showed that OS was similar in DM- and DM+ patients, but diagnosis of DM had a profound impact on OS in the RN group. This supports the guideline statements and offers evidence that urologists should prioritize nephron sparing surgery in patients with DM and Stage I Renal Cell Carcinoma. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e543 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Stephen Ryan More articles by this author Ahmet Bindayi More articles by this author Robert Uzzo More articles by this author Aaron Bloch More articles by this author Madhumitha Reddy More articles by this author Zachary Hamilton More articles by this author Ryan Nasseri More articles by this author Kendrick Yim More articles by this author Fang Wan More articles by this author Umberto Capitanio More articles by this author Alessandro Larcher More articles by this author Francesco Montorsi More articles by this author Sabrina Noyes More articles by this author Sumi Dey More articles by this author Shreyas Joshi More articles by this author Brian Lane More articles by this author Ithaar Derweesh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...