MP80-19 IS RENAL VOLUME AND FUNCTION COMPROMISED IN ONCOCYTOMA PATIENTS ON ACTIVE SURVEILLANCE?

Abstract

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging/Surveillance III (MP80)1 Apr 2020MP80-19 IS RENAL VOLUME AND FUNCTION COMPROMISED IN ONCOCYTOMA PATIENTS ON ACTIVE SURVEILLANCE? Amandip Cheema*, Arun Menon, Tashionna White, Gaybrielle James, and Eric Kauffman Amandip Cheema*Amandip Cheema* More articles by this author , Arun MenonArun Menon More articles by this author , Tashionna WhiteTashionna White More articles by this author , Gaybrielle JamesGaybrielle James More articles by this author , and Eric KauffmanEric Kauffman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000972.019AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The oncologic safety of active surveillance in renal oncocytoma is well reported. However concern remains at the hypothetical possibility of renal functional deterioration due to mechanical effects of an enlarging tumor on normal renal parenchyma. Here we tested this hypothesis by evaluating renal functional outcomes of oncocytoma tumors on AS, including 3-dimension (3-D) imaging software to measure ipsilateral renal parenchymal volumetric changes in patients with large and/or actively growing oncocytoma tumors. METHODS: A renal tumor AS database at Roswell Park Comprehensive Cancer Center was queried to identify all renal oncocytoma patients with at least 18 months follow up on AS. Renal functional outcomes (Cr, GFR) were retrospectively reviewed to determine changes during AS. Tumor volume was calculated using the formula 0.5362*x*y*z when 3 dimensions were available and 0.5362*x*y*(x+y/2) when two dimensions were available. Oncocytoma patients with an estimated volume increase on AS of at least 10 cm3 were selected for automated 3-D volumetric assessment of the tumor and ipsilateral renal parenchyma using CT images with Myrian ® software. Ipsilateral renal parenchymal volume and tumor volume were compared between first and last available CT images. RESULTS: Among a total of 32 oncocytoma patients on AS, 22 with at least 18 months follow up were identified (median 33, mean 37.5, range 19-95 months). Median (mean) estimated tumor volume for these 22 patients was 8.5 cm3 (27.3 cm3) at AS initiation compared to 16.8 cm3 (42.73 cm3) at last follow up. Median (mean) Cr and GFR for these 22 patients was 1.02 mg/dl and 70.9 ml/min/1.73m2 (1.0 and 68.6) at AS initiation compared to 0.89 mg/dl and 79.5 ml/min/1.73m2 (0.9 and 74.2) at last follow up. A total of 9 patients were identified with estimated volume increase of at least 10 cc on AS, most of whom had tumor size >5 cm at last follow up. Tumor volumes calculated for these 9 patients using 3-D imaging software (range 11.3-222) correlated well with estimated tumor volumes (range 9.2-232). The median change in 3-D tumor volume on AS was 26.1 cm3 (mean 40.5, range 12.2-108), while the median change in normal renal parenchymal volume was 4.0 cm3 (mean -1.6, range -35-23). 6/9 (67%) tumors had minimal-to-no decrease (10 cm3 or more) in 3-D renal parenchymal volume on AS. CONCLUSIONS: Loss of renal parenchyma and function may be uncommon in oncocytoma patients regardless of tumor growth and size. This result supports the renal functional safety of AS for oncocytoma, however larger studies with longer follow up and larger tumor volume increases are needed. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1233-e1234 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Amandip Cheema* More articles by this author Arun Menon More articles by this author Tashionna White More articles by this author Gaybrielle James More articles by this author Eric Kauffman More articles by this author Expand All Advertisement PDF downloadLoading ...