PD07-11 TUMOR CONTACT SURFACE AREA AS A PREDICTOR OF FUNCTIONAL OUTCOMES AFTER PARTIAL NEPHRECTOMY

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy I1 Apr 2018PD07-11 TUMOR CONTACT SURFACE AREA AS A PREDICTOR OF FUNCTIONAL OUTCOMES AFTER PARTIAL NEPHRECTOMY Chalairat Suk-Ouichai, Wen Dong, Jitao Wu, Hajime Tanaka, JJ H. Zhang, Elvis R. Caraballo, Erick Remer, Jianbo Li, Sudhir Isharwal, and Steven C. Campbell Chalairat Suk-OuichaiChalairat Suk-Ouichai More articles by this author , Wen DongWen Dong More articles by this author , Jitao WuJitao Wu More articles by this author , Hajime TanakaHajime Tanaka More articles by this author , JJ H. ZhangJJ H. Zhang More articles by this author , Elvis R. CaraballoElvis R. Caraballo More articles by this author , Erick RemerErick Remer More articles by this author , Jianbo LiJianbo Li 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.2018.02.444AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES New baseline glomerular filtration rate (GFR) can be a major factor for cancer survivorship after renal cancer surgery. Parenchymal mass preservation is the predominant factor associated with functional outcomes after partial nephrectomy (PN). Contact surface area (CSA) between the tumor and parenchyma may impact parenchymal preservation and predict functional outcomes after PN. We evaluated CSA as a predictor of parenchymal mass and function preserved by PN. METHODS 419 patients managed with PN had necessary studies to evaluate preoperative and postoperative parenchymal mass and renal function within the operated kidney. Patients with multifocal renal masses were excluded. Parenchymal mass in the operated kidney and CSA were measured using contrast-enhanced CT within 2 months prior to and 3-12 months after PN. CSA was calculated using mathematical formula: 2πrd, where r=radius and d=intraparenchymal depth of tumor. Pearson correlation evaluated relationships between CSA and parenchymal mass or GFR preservation. Multivariable linear regression assessed predictors for GFR preservation. Conceptually, the formula for CSA should function best for exophytic tumors, while predictive value for endophytic tumors may not be as strong. RESULTS Median tumor size and R.E.N.A.L. were 3.5 cm and 8, respectively. Median global and ipsilateral GFR preserved were 89% and 79%, respectively. Median ipsilateral parenchymal mass preserved was 85% and significantly higher for exophytic masses (87% vs 83%, p=0.001). Median CSA was 22.8cm2 and significantly less for exophytic masses (19.8cm2 vs 24.6cm2, p=0.02). CSA associated modestly with both ipsilateral GFR and mass preserved (r=0.25 and 0.36, respectively, both p<0.001). On multivariable analysis, CSA associated with ipsilateral GFR preserved for exophytic masses (p=0.011), but not for endophytic ones (p=0.27). Limitations include retrospective design. CONCLUSIONS CSA, which can be estimated preoperatively, associates with parenchymal mass and function saved after PN, although its utility appears to be greatest for exophytic rather than endophytic tumors. Further study will be required to validate the utility of CSA in different clinical settings. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e160-e161 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Chalairat Suk-Ouichai More articles by this author Wen Dong More articles by this author Jitao Wu More articles by this author Hajime Tanaka More articles by this author JJ H. Zhang More articles by this author Elvis R. Caraballo More articles by this author Erick Remer More articles by this author Jianbo Li 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 ...