MP42-02 TUMOR ENUCLEATION: FUNCTIONAL COMPARISON WITH STANDARD PARTIAL NEPHRECTOMY

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV1 Apr 2018MP42-02 TUMOR ENUCLEATION: FUNCTIONAL COMPARISON WITH STANDARD PARTIAL NEPHRECTOMY Wen Dong, Gopal N. Gupta, Robert H. Blackwell, Jitao Wu, Chalairat Suk-Ouichai, Arpeet Shah, Sarah E. Capodice, Marcus L Quek, Elvis Caraballo, Diego Aguilar, Erick Remer, Jianbo Li, Joseph Zabell, Sudhir Isharwal, and Steven C. Campbell Wen DongWen Dong More articles by this author , Gopal N. GuptaGopal N. Gupta More articles by this author , Robert H. BlackwellRobert H. Blackwell More articles by this author , Jitao WuJitao Wu More articles by this author , Chalairat Suk-OuichaiChalairat Suk-Ouichai More articles by this author , Arpeet ShahArpeet Shah More articles by this author , Sarah E. CapodiceSarah E. Capodice More articles by this author , Marcus L QuekMarcus L Quek More articles by this author , Elvis CaraballoElvis Caraballo More articles by this author , Diego AguilarDiego Aguilar More articles by this author , Erick RemerErick Remer More articles by this author , Jianbo LiJianbo Li More articles by this author , Joseph ZabellJoseph Zabell More articles by this author , Sudhir IsharwalSudhir Isharwal More articles by this author , and Steven C. CampbellSteven C. Campbell More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1309AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Tumor enucleation (TE) optimizes parenchymal preservation and could yield better function than standard partial nephrectomy (SPN). However, data about this are controversial. Our study compares functional outcomes for TE and SPN strategies. METHODS Patients managed with partial nephrectomy (PN) with necessary data for analysis of preservation of ipsilateral parenchymal mass and global GFR from two centers were included. All studies were required <2 months prior and 3-12 months after surgery. Patients with solitary kidney or multifocal tumors were excluded. Ipsilateral vascularized parenchymal mass was estimated from contrast-enhanced CT scans preoperatively and postoperatively. Serum creatinine-based estimates of global GFR were also obtained in the same timeframes. Univariable and multivariable linear regression evaluated factors associated with new baseline global GFR. RESULTS Analysis included 71 TE and 373 SPN. Median preoperative global GFR was comparable for TE and SPN (75mL/min/1.73m2 versus 78mL/min/1.73m2, p=0.6). Median tumor size was 3.0cm for TE and 3.3cm for SPN (p=0.03). Median R.E.N.A.L scores were 7 in both cohorts. For TE, warm and zero ischemia were used in 51% and 49%, respectively. For SPN, warm and cold ischemia were used in 72% and 28%, respectively. Capsular closure was performed in 46% of TE and 100% of SPN (p<0.001). Positive margins were found in 8.5% of TE and 4.8% of SPN (p=0.2). Median ipsilateral vascularized parenchymal mass preserved was 95% (IQR=91-100) for TE and 84% (IQR=76-92) for SPN (p<0.001). Median global GFR preserved was 101% (IQR=93-111) and 89% (IQR=81-96) for TE and SPN, respectively (p<0.001). On multivariable analysis, resection strategy, preoperative GFR, and vascularized parenchymal mass preserved all associated significantly with new baseline global GFR (all p<0.001). Limitations include retrospective design and lack of resection outcome data. CONCLUSIONS Our analysis suggests that TE has potential to maximally preserve parenchymal mass compared to SPN and may provide optimized functional recovery. Further investigation will be required to evaluate the clinical significance of these findings. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e536 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Wen Dong More articles by this author Gopal N. Gupta More articles by this author Robert H. Blackwell More articles by this author Jitao Wu More articles by this author Chalairat Suk-Ouichai More articles by this author Arpeet Shah More articles by this author Sarah E. Capodice More articles by this author Marcus L Quek More articles by this author Elvis Caraballo More articles by this author Diego Aguilar More articles by this author Erick Remer More articles by this author Jianbo Li More articles by this author Joseph Zabell More articles by this author Sudhir Isharwal More articles by this author Steven C. Campbell More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...