MP49-03 ROBOTIC-ASSISTED PARTIAL NEPHRECTOMY (RAPN) FOR MULTIFOCAL SOLID RENAL CELL MASSES (SRM): PATHOLOGIC CONCORDANCE RATES AND SURGICAL OUTCOMES

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV (MP49)1 Sep 2021MP49-03 ROBOTIC-ASSISTED PARTIAL NEPHRECTOMY (RAPN) FOR MULTIFOCAL SOLID RENAL CELL MASSES (SRM): PATHOLOGIC CONCORDANCE RATES AND SURGICAL OUTCOMES Tara Morgan, Jessica Dai, Vineeth Kommidi, Sam Kusin, Jeffrey Gahan, and Jeffrey Cadeddu Tara MorganTara Morgan More articles by this author , Jessica DaiJessica Dai More articles by this author , Vineeth KommidiVineeth Kommidi More articles by this author , Sam KusinSam Kusin More articles by this author , Jeffrey GahanJeffrey Gahan More articles by this author , and Jeffrey CadedduJeffrey Cadeddu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002075.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Treatment of patients with multifocal kidney cancer requires forward thinking care, as they are at risk for recurrent surgeries with higher complication rates and progression to end stage renal disease (ESRD). Biopsy or imaging must be convincing for malignancy and if intervention is necessary, nephron sparing surgery (NSS) is favored. We present outcomes and pathologic concordance rates. METHODS: A retrospective chart review was performed on 58 patients with 2 or more ipsilateral SRMs who underwent RAPN between 10/2011 and 9/2019. Peri-operative and pathologic details were recorded. Clinical characteristics were analyzed using SPSS (IBM, Armonk, NY). Wilcoxon signed rank test compared a change in post-operative GFR from baseline. RESULTS: Pre-operative patient and tumor characteristics are in Table 1. 15 (25.9%) also had 1+ contralateral tumors and 9 (15.5%) had a solitary kidney. In total, 152 tumors were removed (mean 2.62 tumors/pt), of which 148 (97.4%) had final pathology (Table 2). Concordance rate between concurrent ipsilateral tumors was low at only 55.2%. The most recent median post-operative eGFR (68.0, IQR 53.0-84.0) obtained at a median of 24.9 months (IQR 9.3-50.6) was significantly lower than pre-operative baseline of 77 (IQR 69.0-92.0), p<0.001. Mean OR time, median blood loss, warm ischemia times and lengths of stay were 209.8 min (SD+/-48.1), 200.0 cc (IQR 100.0-340.0), 32.0 minutes (IQR 23.0-38.0), and 2.0 days (IQR 2.0-3.0), respectively. There was a positive margin in 5 patients (8.6%) and a complication in 8 (13.8%). A local tumor bed recurrence occurred in 3 patients (5.2%) over a median follow up of 20.4 months (IQR 6.7-42.2). CONCLUSIONS: Ipsilateral tumor concordance rates are low, bringing into question the utility of pre-operative biopsy in this patient population. In expert hands, RAPN is a safe in patients with multifocal tumors, with complication and recurrence rates similar to unifocal tumor cases. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e875-e875 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tara Morgan More articles by this author Jessica Dai More articles by this author Vineeth Kommidi More articles by this author Sam Kusin More articles by this author Jeffrey Gahan More articles by this author Jeffrey Cadeddu More articles by this author Expand All Advertisement Loading ...