PD12-12 BILATERAL RENAL CELL CARCINOMA: NEOADJUVANT TYROSINE KINASE INHIBITOR HELPS PRESERVE RENAL FUNCTION PRIOR TO ROBOTIC PARTIAL NEPHRECTOMY

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy I (PD12)1 Sep 2021PD12-12 BILATERAL RENAL CELL CARCINOMA: NEOADJUVANT TYROSINE KINASE INHIBITOR HELPS PRESERVE RENAL FUNCTION PRIOR TO ROBOTIC PARTIAL NEPHRECTOMY Jiping Zeng, Aye Lwin, Ava Wong, Ken Batai, and Benjamin Lee Jiping ZengJiping Zeng More articles by this author , Aye LwinAye Lwin More articles by this author , Ava WongAva Wong More articles by this author , Ken BataiKen Batai More articles by this author , and Benjamin LeeBenjamin Lee More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001987.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Tyrosine kinase inhibitors (TKI) have the theoretical advantage of downsizing renal cell carcinoma (RCC) to facilitate nephron-sparing surgery while preserving renal function with concomitant oncologic efficacy. In this study, we report oncological and functional outcomes of patients with bilateral renal masses in the contemporary era of TKIs. METHODS: After Institutional Review Board approval, 521 RCC patients were treated at the Department of Urology at the University of Arizona between 2010 – 2019 were reviewed. Patients who presented with bilateral renal masses were selected for analysis. Surgical approach, percent decrease in size following TKI, change in renal function, time interval between surgeries, and recurrence rates were reviewed. RESULTS: A subset of 35 renal units were included in the analysis. The TKI cohort (n=6) between 2017-2019, was compared to the naïve treatment cohort (n=29), during 2010 - 2019. In TKI group, 66.7% of tumors were downsized sufficiently to allow partial nephrectomy. Average tumor size was 6.18 cm and 5.55 cm in TKI and no-TKI group, respectively. In TKI group, there was an average of 49.2% decrease in tumor size. Compared to 18.6% creatinine rise postoperatively in no-TKI group, patients with TKI use had a greater rise in creatinine, of 19.7%. However, no statistical difference was noted (p=0.93). Both groups have no recurrence at the most recent follow-up, with median of 22 months (1-91) and 10 months (1-36). CONCLUSIONS: TKI plays a greater role in preserving renal function while maintaining oncological efficacy. Downsizing of tumors with TKI by 49% allows nephron-sparing surgery to be performed to minimize renal failure and risk of dialysis. Prospective studies are required to validate the oncologic efficacy and persistent benefit. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e208-e208 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jiping Zeng More articles by this author Aye Lwin More articles by this author Ava Wong More articles by this author Ken Batai More articles by this author Benjamin Lee More articles by this author Expand All Advertisement Loading ...