MP30-03 THE EFFICACY OF ROBOTIC PARTIAL NEPHRECTOMY IN T1B TUMORS: COMPARATIVE ANALYSIS.

Abstract

INTRODUCTION AND OBJECTIVES: We evaluated the perioperative and postoperative outcomes between T1a and T1b patients with Renal Cell Carcinoma who underwent robotic partial nephrectomy. METHODS: 86 patients with clinically T1a renal tumor and 39 patients with clinically T1b RCC underwent a warm ischemia robotic partial nephrectomy, from 2008 to 2012. Patients who underwent off clamp robotic partial nephrectomy were excluded from the study. Operative and warm ischemia time, serum creatinine, estimated Glomerular Filtration Rate (eGFR), blood loss, days of drain preservation and hospitalization, surgical complications and positive margins were estimated in both cohorts and analyzed with SPSS v 18. RESULTS: Baseline characteristics were similar in both cohorts. Significant differences existed between the two cohorts with regard to operative time (p1⁄40.03), warm ischemia time (p1⁄40.01) and estimated blood loss (p1⁄40.001). In T1b cohort there was a trend towards increased surgical complications grade III according to modified Clavien-Diado classification system (p1⁄40.053). Postoperative serum Creatinine and eGFR, days of drain preservation and hospitalization, and positive surgical margins were not significant different between the two cohorts. Patients with 4-5cm. tumors had also longer operating time (p1⁄40.009), longer warm ischemia time (p1⁄40.01) and higher blood loss (p1⁄40.001) compared to patients with T1a tumors. These differences did not exist between patients with 4-5cm. and 57cm. RCC Operative time was the only variable which could predict the existence of surgical complications in binary multivariate logistic regression analysis (p1⁄40.019). CONCLUSIONS: Robotic partial nephrectomy is a feasible and safe approach, but differences in operative outcomes exist between T1a and T1b RCC. Operative time, warm ischemia time, blood loss and surgical complications are increased in T1b tumors in contrast with T1a tumors, without affecting the functional and the oncologic outcome. Source of Funding: none