MP22-01 PERIOPERATIVE MORBIDITY, ONCOLOGICAL OUTCOMES AND PREDICTORS OF PT3A UPSTAGING FOR PATIENTS UNDERGOING PARTIAL NEPHRECTOMY FOR CT1 TUMORS

Abstract

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging I1 Apr 2017MP22-01 PERIOPERATIVE MORBIDITY, ONCOLOGICAL OUTCOMES AND PREDICTORS OF PT3A UPSTAGING FOR PATIENTS UNDERGOING PARTIAL NEPHRECTOMY FOR CT1 TUMORS Pascal Mouracade, Onder Kara, Julien Dagenais, Matthew Maurice, Ryan Nelson, Ercan Malkoc, Jaya Sai Chavali, and Jihad Kaouk Pascal MouracadePascal Mouracade More articles by this author , Onder KaraOnder Kara More articles by this author , Julien DagenaisJulien Dagenais More articles by this author , Matthew MauriceMatthew Maurice More articles by this author , Ryan NelsonRyan Nelson More articles by this author , Ercan MalkocErcan Malkoc More articles by this author , Jaya Sai ChavaliJaya Sai Chavali More articles by this author , and Jihad KaoukJihad Kaouk More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.655AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The question of whether upstaged and nonupstaged tumors have different outcomes continue to be discussed in the literature. Few published studies address this question, with a wide range of results. The aim of this study was to evaluate perioperative morbidity, oncological outcome and predictors of pT3a upstaging after partial nephrectomy(PN). METHODS Retrospective study of 1042 patients who underwent PN for cT1 renal cell carcinoma between 2007 and 2015. A total of 113 cT1 patients were upstaged to pT3a, while 929 were staged pT1. Demographic, perioperative and pathological variables were reviewed. We compared the clinico-pathological characteristics, perioperative morbidity and oncological outcomes between pT3a and pT1 groups. Multivariate regression evaluates variables associated with T3a upstaging. Progression-free survival (PFS) and overall survival analyses were performed. RESULTS pT3a tumors had a higher R.E.N.A.L score, higher hilar location, higher grade, and higher positive surgical margins. Patients with pT3a had a higher estimated blood loss, transfusion rate, ischemia time, overall complications, while there were no difference in median e-GFR decline and major (Grade III-V) complications. Five-year PFS was 78.5% for pT3a group, vs 94.6% for pT1 group (Log rank p <0.01). Male gender (OR 2.2, p<0.01), and R.E.N.A.L score (OR 2.3, p=0.01) were preoperative predictors of upstaging. CONCLUSIONS Perioperative morbidity is acceptable in pT3 tumors, however upstaged patients had a worse oncological outcomes. cT1/pT3a tumors are associated with adverse clinico-pathological features. Preoperative risk predictors of upstaging were, higher R.E.N.A.L score and male gender. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e256 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Pascal Mouracade More articles by this author Onder Kara More articles by this author Julien Dagenais More articles by this author Matthew Maurice More articles by this author Ryan Nelson More articles by this author Ercan Malkoc More articles by this author Jaya Sai Chavali More articles by this author Jihad Kaouk More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...