PD43-11 IMPACT OF CYTOREDUCTIVE NEPHRECTOMY ON PATIENT REPORTED OUTCOMES

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD43-11 IMPACT OF CYTOREDUCTIVE NEPHRECTOMY ON PATIENT REPORTED OUTCOMES Daniel Shapiro, Viraj Master, Juliana Craig, Dattatraya Patil, Tudor Borza, Glenn Allen, Kyle Richards, David Jarrard, and E. Jason Abel Daniel ShapiroDaniel Shapiro More articles by this author , Viraj MasterViraj Master More articles by this author , Juliana CraigJuliana Craig More articles by this author , Dattatraya PatilDattatraya Patil More articles by this author , Tudor BorzaTudor Borza More articles by this author , Glenn AllenGlenn Allen More articles by this author , Kyle RichardsKyle Richards More articles by this author , David JarrardDavid Jarrard More articles by this author , and E. Jason AbelE. Jason Abel More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003353.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: One goal of cytoreductive nephrectomy (CN) is to improve patients’ quality of life, but few studies have used validated patient reported outcomes (PROs) metrics to quantify the benefit of CN. The NCCN FKSI-19 is a validated 19-item questionnaire that measures tumor-specific PROs in patients with kidney cancer. This study evaluated changes in PROs in mRCC patients before and after treatment with CN using the FKSI-19 instrument. METHODS: Patients undergoing upfront CN were recruited at two institutions over two years to complete FKSI-19 forms within 30 days preoperatively and 4-6 weeks postoperatively. The FKSI-19 score ranges from 0-76 with higher scores indicating fewer symptoms. The FKSI-19 contains subdomains including disease related symptoms (DRS), DRS-emotional (DRS-E), DRS-physical (DRS-P) and functional wellbeing (FWB). Wilcoxon matched-pairs signed rank test and Fisher’s exact test were used to compare pre- and postoperative scores. Clinically meaningful improvements in FKSI-19 score were considered if the score increased ≥5 points postoperatively based on prior studies. Logistic regression was used to determine variables associated with meaningful improvements in FKSI scores. RESULTS: A total of 25 patients completed a pre and postop FKSI. Median preop FKSI was 57 (IQR 47-63) and postop 59 (IQR 51-64) (p=0.2) with a median change of+3 points. Tumor size, gender, surgical approach (open vs. laparoscopic), age, and race were not associated with change in FKSI postoperatively (p>0.05 for all). Among the domains, the DRS-E score, which ranges from 0-4, significantly improved postop (median 2 vs 3, p<0.001), indicating patients were less worried their cancer would worsen after CN. 11/25 (44%) patients had meaningful improvements in postop FKSI. Preop FKSI score was inversely associated with meaningful improvements in postop FKSI (OR 0.89 95%CI 0.8-0.96, p=0.02). The patient with the largest improvement in FKSI score was the most symptomatic preoperatively (Figure 1). CONCLUSIONS: Patients had significantly less worry about cancer progression after CN. Patients that had the most improvement in PROs tended to be more symptomatic prior to CN. This study is limited by variability in timing of the postop FKSI. Continued prospective evaluation of CN PROs will help define which patients are most likely to benefit from CN. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1122 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniel Shapiro More articles by this author Viraj Master More articles by this author Juliana Craig More articles by this author Dattatraya Patil More articles by this author Tudor Borza More articles by this author Glenn Allen More articles by this author Kyle Richards More articles by this author David Jarrard More articles by this author E. Jason Abel More articles by this author Expand All Advertisement PDF downloadLoading ...