PD66-09 UTILIZATION OF ROBOTIC VERSUS OPEN PARTIAL NEPHRECTOMY FOR MANAGEMENT OF CT1 AND CT2 RENAL MASSES

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy VI1 Apr 2017PD66-09 UTILIZATION OF ROBOTIC VERSUS OPEN PARTIAL NEPHRECTOMY FOR MANAGEMENT OF CT1 AND CT2 RENAL MASSES Mahmoud Alameddine, Tulay Koru-Sengul, Feng Miao, Luís Felipe Sávio, Ian Zheng, Vivek Venkatramani, Nachiketh Soodana Prakash, Joshua S Jue, Bruno Nahar, Chad Ritch, Sanoj Punnen, Dipen J. Parekh, and Mark L. Gonzalgo Mahmoud AlameddineMahmoud Alameddine More articles by this author , Tulay Koru-SengulTulay Koru-Sengul More articles by this author , Feng MiaoFeng Miao More articles by this author , Luís Felipe SávioLuís Felipe Sávio More articles by this author , Ian ZhengIan Zheng More articles by this author , Vivek VenkatramaniVivek Venkatramani More articles by this author , Nachiketh Soodana PrakashNachiketh Soodana Prakash More articles by this author , Joshua S JueJoshua S Jue More articles by this author , Bruno NaharBruno Nahar More articles by this author , Chad RitchChad Ritch More articles by this author , Sanoj PunnenSanoj Punnen More articles by this author , Dipen J. ParekhDipen J. Parekh More articles by this author , and Mark L. GonzalgoMark L. Gonzalgo More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2972AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Partial nephrectomy is widely utilized for surgical management of small renal masses. Robotic partial nephrectomy (RPN) has demonstrated improved postoperative morbidity and comparable oncologic outcomes compared to open partial nephrectomy (OPN). However, there is limited data regarding the utilization of RPN across different socio-economic strata and racial groups in the United States. We investigated trends and disparities in utilization of RPN for management of cT1 and cT2 renal masses. METHODS Patients who underwent RPN and OPN for clinical stage T1 and T2, N0, M0 renal masses from 2010 to 2013 were identified in the National Cancer Data Base (NCDB). Univariate and multivariable logistic regression analyses were performed to evaluate differences in receiving RPN across various patient groups. RESULTS A total of 23,681 patients fulfilled inclusion criteria. Utilization of RPN for management of cT1/cT2 renal masses significantly increased from 2010 to 2013 compared to OPN (Figure.1). Black (aOR=0.91, 95%CI: 0.84-0.99) and Hispanic (aOR=0.85, 95% CI: 0.76-0.94) patients were less likely to undergo RPN in favor of OPN. RPN was less likely to be performed in rural counties (aOR= 0.81, 95% CI: 0.66-0.98) and in patients with no insurance (aOR=0.52, 95% CI: 0.45-0.61) or patients covered by Medicaid (aOR=0.81, CI: 0.73-0.89). No significant difference was seen with respect to utilization of RPN between academic and non-academic facilities. Patients with higher clinical stage and co-morbidities were also less likely to undergo RPN (aOR=0.23, 95% CI: 0.15- 0.36 and 0.79, 95% CI: 0.71-0.87 respectively). CONCLUSIONS Utilization of RPN continues to increase over time; however, there is significant disparity in utilization of RPN based on socio-economic status and race. Black or Hispanic patients and patients in rural communities and with limited insurance were more likely to be treated with OPN instead of RPN. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1275 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Mahmoud Alameddine More articles by this author Tulay Koru-Sengul More articles by this author Feng Miao More articles by this author Luís Felipe Sávio More articles by this author Ian Zheng More articles by this author Vivek Venkatramani More articles by this author Nachiketh Soodana Prakash More articles by this author Joshua S Jue More articles by this author Bruno Nahar More articles by this author Chad Ritch More articles by this author Sanoj Punnen More articles by this author Dipen J. Parekh More articles by this author Mark L. Gonzalgo More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...