MP35-08 HISTOPATHOLOGICAL EVALUATION OF NON-NEOPLASTIC RENAL PARENCHYMA IS MORE PROMISING THAN SOPHISTICATED FILM TECHNOLOGY FOR THE PREDICTION OF POST-PARTIAL NEPHRECTOMY RENAL FUNCTION

Abstract

You have accessJournal of UrologyKidney Cancer: Evaluation and Staging I1 Apr 2015MP35-08 HISTOPATHOLOGICAL EVALUATION OF NON-NEOPLASTIC RENAL PARENCHYMA IS MORE PROMISING THAN SOPHISTICATED FILM TECHNOLOGY FOR THE PREDICTION OF POST-PARTIAL NEPHRECTOMY RENAL FUNCTION Takehiro Sejima, Noriya Yamaguchi, Hideto Iwamoto, Toshihiko Masago, Shuichi Morizane, Masashi Honda, and Atsushi Takenaka Takehiro SejimaTakehiro Sejima More articles by this author , Noriya YamaguchiNoriya Yamaguchi More articles by this author , Hideto IwamotoHideto Iwamoto More articles by this author , Toshihiko MasagoToshihiko Masago More articles by this author , Shuichi MorizaneShuichi Morizane More articles by this author , Masashi HondaMasashi Honda More articles by this author , and Atsushi TakenakaAtsushi Takenaka More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1109AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To explore new factors that are predictive of post-partial nephrectomy (PN) renal function, we analyzed various clinico-pathological factors with a special focus on renal volume measured via three-dimensional imaging technology and histopathological parameters in non-neoplastic parenchyma (Figure). METHODS Estimated glomerular filtration rates (eGFRs) were determined pre-operatively and during a post-operative stable period of 3 to 12 mo. The percent eGFR decline was calculated in 52 patients treated by PN. The factors analyzed included the 3 to 6 mo. post-operative changing rate of renal volume in the healthy side and complete bilateral side, which was measured using the volume analyzer SYNAPSE VINCENT (Fujifilm), as well as the extent of global glomerulosclerosis (GS) in non-neoplastic parenchyma. Additional factors analyzed included age, gender, body mass index, smoking history, pre-operative eGFR, tumor diameter, tumor pathology (benign vs. malignant), surgery type (robot assisted vs. others), ischemic method (total vs. selective arterial clumping), ischemic time, and existence of various comorbidities. Uni- and multivariable logistic regression analyses were utilized for the determination of predictors of post-PN renal function. RESULTS Three groups were categorized according to the degree of eGFR decline; groups A (n = 15), B (n = 24), and C (n = 13) were categorized less than 0 %, 0 to 15 %, and greater than 15 % of eGFR decline, respectively. Greater than 10 % global GS (P = 0.0086), proteinuria (P = 0.0456), and pre-operative eGFR (P = 0.044) were significantly predictive of the C group in the univariate analysis, whereas more than 10 % global GS was the sole independent predictor of the C group (P = 0.0457). Renal volume calculated by SYNAPSE VINCENT did not exhibit statistical significance. CONCLUSIONS The Collage of American Pathologists advocates the post-operative clinical importance of histopathological evaluation in normal renal parenchyma of radical nephrectomy specimens. This recommendation is equally suggested in PN cases utilizing the evaluation of GS extent in a rim of non-neoplastic parenchyma as a promising biomarker of renal function. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e421-e422 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Takehiro Sejima More articles by this author Noriya Yamaguchi More articles by this author Hideto Iwamoto More articles by this author Toshihiko Masago More articles by this author Shuichi Morizane More articles by this author Masashi Honda More articles by this author Atsushi Takenaka More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...