MP49-14 COMPARISON OF DIFFERENTIAL FUNCTIONAL OUTCOMES AFTER PARTIAL NEPHRECTOMY BETWEEN MODERATE AND HIGH COMPLEX RENAL TUMOR EVALUATED WITH DIETHYLENETRIAMINE PENTAACETIC ACID SCAN: A PROPENSITY SCORE MATCHED ANALYSIS

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV (MP49)1 Sep 2021MP49-14 COMPARISON OF DIFFERENTIAL FUNCTIONAL OUTCOMES AFTER PARTIAL NEPHRECTOMY BETWEEN MODERATE AND HIGH COMPLEX RENAL TUMOR EVALUATED WITH DIETHYLENETRIAMINE PENTAACETIC ACID SCAN: A PROPENSITY SCORE MATCHED ANALYSIS Hwanik Kim, Jin Noh, Jae Won Lee, Sang Hun Song, Hakju Kim, Jung Kwon Kim, Hakmin Lee, Sangchul Lee, Jong Jin Oh, Seong jin Jeong, Sung Kyu Hong, and Seok-Soo Byun Hwanik KimHwanik Kim More articles by this author , Jin NohJin Noh More articles by this author , Jae Won LeeJae Won Lee More articles by this author , Sang Hun SongSang Hun Song More articles by this author , Hakju KimHakju Kim More articles by this author , Jung Kwon KimJung Kwon Kim More articles by this author , Hakmin LeeHakmin Lee More articles by this author , Sangchul LeeSangchul Lee More articles by this author , Jong Jin OhJong Jin Oh More articles by this author , Seong jin JeongSeong jin Jeong More articles by this author , Sung Kyu HongSung Kyu Hong More articles by this author , and Seok-Soo ByunSeok-Soo Byun More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002075.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Renal function after partial nephrectomy (PN) depends on a complex of clinical conditions including preoperative parenchymal quality, postop parenchymal quantity, and the recovery of remaining nephrons from ischemic damages. However, the natural history and definitive predictors of long-term RF after PN in renal tumors with RENAL nephrometry score (RENAL) of 7-9 (moderate complex, M) or RENAL of 10-12 (high complex, H) remain unclear. Thus, the aim of the present study was to compare functional outcomes evaluated with diethylenetriamine pentaacetic acid (DTPA) scan and Modification of Diet in Renal Disease (MDRD) formula after PN between M and H renal tumors. METHODS: In 2004/01-2019/12, 471 patients with RNS 7-9 (M) and 164 with RNS 10-12 (H) who underwent PN were analyzed for renal function outcomes. Glomerular filtration rate (GFR) measured from DTPA scan, calculated GFR using Modification of Diet in Renal Disease (MDRD) formula, Trifecta/Pentafecta outcome, recurrence free survival (RFS), and overall survival (OS) were compared after propensity score matching analysis (PSMA). RESULTS: After PSMA, 156 cases in each group were matched without significant difference in preoperative factor. At postoperative (postop) 1st year, there was no significant difference in Trifecta (p=0.320), MDRD-based (p=0.729), or DTPA-based Pentafecta achievement rate (p=0.964) between groups. At postop 5 years, DTPA-based total GFR (93.6% vs. 93.8%) and operated kidney GFR preservation rate (89.9% vs. 81.7%) did not differ significantly (p>0.05). Kaplan-Meier survival analysis showed no significant differences in survival outcomes (p>0.05). Significant predictors of de novo chronic kidney disease (CKD) stage ≥3 at postop 1st year were age (Hazard ratio (HR): 1.10, 95% CI: 1.03-1.17, p=0.005) and preoperative DTPA-based total GFR (HR: 0.94, 95% CI: 0.91-0.98, p=0.001). CONCLUSIONS: High complex tumor can be treated with PN without significant renal function deterioration. Postoperative operated kidney’s function is preserved up to 80% in the long term. However, PN should be selectively performed with caution to avoid occurrence of postop CKD. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e881-e881 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hwanik Kim More articles by this author Jin Noh More articles by this author Jae Won Lee More articles by this author Sang Hun Song More articles by this author Hakju Kim More articles by this author Jung Kwon Kim More articles by this author Hakmin Lee More articles by this author Sangchul Lee More articles by this author Jong Jin Oh More articles by this author Seong jin Jeong More articles by this author Sung Kyu Hong More articles by this author Seok-Soo Byun More articles by this author Expand All Advertisement Loading ...