PD07-11 PARTIAL VERSUS RADICAL NEPHRECTOMY FOR COMPLEX RENAL MASS: MULTICENTER COMPARATIVE ANALYSIS OF FUNCTIONAL OUTCOMES (ROSULA COLLABORATIVE GROUP) (2023)

You have accessJournal of UrologyCME1 Apr 2023PD07-11 PARTIAL VERSUS RADICAL NEPHRECTOMY FOR COMPLEX RENAL MASS: MULTICENTER COMPARATIVE ANALYSIS OF FUNCTIONAL OUTCOMES (ROSULA COLLABORATIVE GROUP) Clara Cerrato, Margaret F. Meagher, Riccardo Autorino, Giuseppe Simone, Bo Yang, Robert Uzzo, Francesco Porpiglia, Umberto Capitanio, James Porter, Alp T Beksac, Mimi Nguyen, Savio D Pandolfo, Kevin Hakimi, Luke Wang, Andrea Minervini, Clayton Lau, Monish Aron, Daniel Eun, Alexandre Mottrie, Aalst Belgium, Carmen Mir, Chandru Sundaram, Alessandro Antonelli, Jihad Kaouk, and Ithaar H Derweesh Clara CerratoClara Cerrato More articles by this author , Margaret F. MeagherMargaret F. Meagher More articles by this author , Riccardo AutorinoRiccardo Autorino More articles by this author , Giuseppe SimoneGiuseppe Simone More articles by this author , Bo YangBo Yang More articles by this author , Robert UzzoRobert Uzzo More articles by this author , Francesco PorpigliaFrancesco Porpiglia More articles by this author , Umberto CapitanioUmberto Capitanio More articles by this author , James PorterJames Porter More articles by this author , Alp T BeksacAlp T Beksac More articles by this author , Mimi NguyenMimi Nguyen More articles by this author , Savio D PandolfoSavio D Pandolfo More articles by this author , Kevin HakimiKevin Hakimi More articles by this author , Luke WangLuke Wang More articles by this author , Andrea MinerviniAndrea Minervini More articles by this author , Clayton LauClayton Lau More articles by this author , Monish AronMonish Aron More articles by this author , Daniel EunDaniel Eun More articles by this author , Alexandre MottrieAlexandre Mottrie More articles by this author , Aalst BelgiumAalst Belgium More articles by this author , Carmen MirCarmen Mir More articles by this author , Chandru SundaramChandru Sundaram More articles by this author , Alessandro AntonelliAlessandro Antonelli More articles by this author , Jihad KaoukJihad Kaouk More articles by this author , and Ithaar H DerweeshIthaar H Derweesh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003231.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Utility of Partial Nephrectomy (PN) for complex renal mass (CRM) is controversial. We determined the impact of surgical modality on post-operative renal functional outcomes for CRM. METHODS: We retrospectively analyzed a multicenter registry (ROSULA). CRM was defined as RENAL score 10-12. The cohort was divided into PN and radical nephrectomy (RN) for analyses. Primary outcome was development of de-novo estimated glomerular filtration rate (eGFR)<45 ml/min/1.73m2. Secondary outcomes were de-novo eGFR<60 and DeGFR between diagnosis and last follow-up. Cox proportional hazards was used to elucidate predictors for de-novo eGFR<60 and <45. Linear regression was utilized to analyze DeGFR. Kaplan-Meier Analysis (KMA) was performed to analyze 5-year freedom from de-novo eGFR<60 and <45. RESULTS: We analyzed 969 patients (RN=429, PN=540; median follow-up 24.0 months). RN patients had lower BMI (p<0.001) and larger tumor size (p<0.001). Overall post operative complication rate was higher for PN (p<0.001), but there was no difference in major complications (Clavien III-IV; p=0.702). MVA demonstrated age (HR=1.05, p<0.001), tumor size (HR=1.05, p=0.046), RN (HR=2.57, p<0.001), and BMI (HR=1.04, p=0.001) to be associated with risk for de novo eGFR<60 ml/min/1.73m2. Age (HR=1.03, p<0.001), BMI (HR=1.06, p<0.001), baseline eGFR (HR0.99, p=0.002), tumor size (HR1.07, p=0.007) and RN (HR=2.39, p<0.001) were risk factors for de novo eGFR<45 ml/min/1.73m2. RN (B= -10.89, p<0.001) was associated with greater DeGFR (Table 1). KMA revealed worse 5-year freedom from de-novo eGFR<60 (71% vs. 33%, p<0.001) and de-novo eGFR<45 (79% vs. 65%, p<0.001) for RN (Figure 1). CONCLUSIONS: PN provides functional benefit in selected patients with CRM without significant increase in major complications compared to RN and should be considered when technically feasible. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e166 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Clara Cerrato More articles by this author Margaret F. Meagher More articles by this author Riccardo Autorino More articles by this author Giuseppe Simone More articles by this author Bo Yang More articles by this author Robert Uzzo More articles by this author Francesco Porpiglia More articles by this author Umberto Capitanio More articles by this author James Porter More articles by this author Alp T Beksac More articles by this author Mimi Nguyen More articles by this author Savio D Pandolfo More articles by this author Kevin Hakimi More articles by this author Luke Wang More articles by this author Andrea Minervini More articles by this author Clayton Lau More articles by this author Monish Aron More articles by this author Daniel Eun More articles by this author Alexandre Mottrie More articles by this author Aalst Belgium More articles by this author Carmen Mir More articles by this author Chandru Sundaram More articles by this author Alessandro Antonelli More articles by this author Jihad Kaouk More articles by this author Ithaar H Derweesh More articles by this author Expand All Advertisement PDF downloadLoading ...