PD61-07 COMPARATIVE ANALYSIS OF PERIOPERATIVE OUTCOMES FOR PATIENTS WITH 4-7CM RCC TREATED WITH EITHER MICROWAVE ABLATION, PARTIAL NEPHRECTOMY OR RADICAL NEPHRECTOMY

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Ablative Therapy1 Apr 2018PD61-07 COMPARATIVE ANALYSIS OF PERIOPERATIVE OUTCOMES FOR PATIENTS WITH 4-7CM RCC TREATED WITH EITHER MICROWAVE ABLATION, PARTIAL NEPHRECTOMY OR RADICAL NEPHRECTOMY Daniel D. Shapiro, Shane A. Wells, Timothy J. Ziemlewicz, Meghan G. Lubner, J. Louis Hinshaw, Fred T. Lee, David F. Jarrard, Kyle A. Richards, Sara L. Best, Tracy M. Downs, Glenn O. Allen, Stephen Y. Nakada, and E. Jason Abel Daniel D. ShapiroDaniel D. Shapiro More articles by this author , Shane A. WellsShane A. Wells More articles by this author , Timothy J. ZiemlewiczTimothy J. Ziemlewicz More articles by this author , Meghan G. LubnerMeghan G. Lubner More articles by this author , J. Louis HinshawJ. Louis Hinshaw More articles by this author , Fred T. LeeFred T. Lee More articles by this author , David F. JarrardDavid F. Jarrard More articles by this author , Kyle A. RichardsKyle A. Richards More articles by this author , Sara L. BestSara L. Best More articles by this author , Tracy M. DownsTracy M. Downs More articles by this author , Glenn O. AllenGlenn O. Allen More articles by this author , Stephen Y. NakadaStephen Y. Nakada More articles by this author , and E. Jason AbelE. Jason Abel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2831AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Although microwave ablation (MWA) may be used for RCC treatment in older patients with co-morbidities, the perioperative morbidity associated with MWA in larger tumors has not been described in detail. The purpose of this project was to evaluate perioperative outcomes (complications, hospital stay, transfusion rate, readmission rate) for patients with 4-7cm RCC tumors treated with either MWA or surgery. METHODS Comprehensive data was analyzed for consecutive RCC patients with tumors 4-7cm following treatment with MWA, partial nephrectomy (PN) or radical nephrectomy (RN). Patients with metastases or venous thrombus were excluded. Complications within 90 days were classified using the Clavien-Dindo system. Univariate and multivariate Cox analysis was performed to determine factors associated with perioperative outcomes. RESULTS An institutional database identified 42 MWA, 74 PN and 211 RN (n=327) treated from 2000-2017. Perioperative complications were identified in 9 (21%) MWA, 18 (24%) PN and 28 (13%) RN patients. Patients treated with MWA had higher Charlson co-morbidity scores (p<0.0001) and were older (p<0.0001) compared to patients treated surgically. After multivariate analysis, independent predictors of perioperative complications included treatment with PN (vs. MW or RN) HR 2.42 (95%CI 1.23 – 4.76) and prior abdominal surgery HR 2.27 (95%CI 1.21-4.26).Blood transfusion rate was not statistically different among treatments, (4.7% MWA, 8.1% PN, 4.7% RN; p=0.53). Perioperative mortality within 30 days was identified following in 0 MWA, 0 PN and 1/211 (0.5%) RN patients. Median hospital stay was shorter for MWA 1 day (IQR 1-1) vs. PN 4 days (IQR 3-6) or RN 4 days (IQR 3-4), p<0.001. No difference was identified in 30- day re-admission rate among treatments, 7.1% MWA vs, 1.4% PN vs. 2.8% RN, p=0.21. CONCLUSIONS Patients treated with microwave ablation for 4-7cm RCC tumors had shorter length of hospitalization with no differences in 30-day re-admission rate, overall complication rate, or perioperative mortality. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1153-e1154 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Daniel D. Shapiro More articles by this author Shane A. Wells More articles by this author Timothy J. Ziemlewicz More articles by this author Meghan G. Lubner More articles by this author J. Louis Hinshaw More articles by this author Fred T. Lee More articles by this author David F. Jarrard More articles by this author Kyle A. Richards More articles by this author Sara L. Best More articles by this author Tracy M. Downs More articles by this author Glenn O. Allen More articles by this author Stephen Y. Nakada More articles by this author E. Jason Abel More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...