You have accessJournal of UrologyCME1 May 2022MP16-04 PRACTICE-LEVEL VARIATION IN RATES POSITIVE SURGICAL MARGINS AT PARTIAL NEPHRECTOMY: A MUSIC-KIDNEY ANALYSIS Mohit Butaney, Sonia Bhayani, Ji Qi, Anna Johnson, Sara Perkins, Sabrina Noyes, Alon Weizer, Lewis Johnson, Amit Patel, Alice Semerjian, Brian Lane, Craig Rogers, and for the Michigan Urological Surgery Improvement Collaborative Mohit ButaneyMohit Butaney More articles by this author , Sonia BhayaniSonia Bhayani More articles by this author , Ji QiJi Qi More articles by this author , Anna JohnsonAnna Johnson More articles by this author , Sara PerkinsSara Perkins More articles by this author , Sabrina NoyesSabrina Noyes More articles by this author , Alon WeizerAlon Weizer More articles by this author , Lewis JohnsonLewis Johnson More articles by this author , Amit PatelAmit Patel More articles by this author , Alice SemerjianAlice Semerjian More articles by this author , Brian LaneBrian Lane More articles by this author , Craig RogersCraig Rogers More articles by this author , and for the Michigan Urological Surgery Improvement Collaborative More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002549.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The aim of partial nephrectomy (PN) is to completely excise the small renal mass while optimizing renal parenchymal preservation and minimizing morbidity to the patient. While focal PSM have not conclusively been associated with local recurrence in published series, they lead to increased patient anxiety and intensity of surveillance. MUSIC-KIDNEY is a state-wide quality improvement collaborative focused on reducing the burden of care for patients with clinical T1 renal masses (cT1RM). PSM rate represents a surrogate of surgical quality in this patient population. As part of a quality improvement initiative to improve rates of PSM, we evaluated the influence of practice-level variation, patient, and tumor factors on PSM rates in the MUSIC-KIDNEY cohort. METHODS: MUSIC-KIDNEY commenced data collection in June 2017 and now includes >3500 patients with newly diagnosed cT1RM. Data abstractors record clinical data for patients at 16 MUSIC practices including >90 physicians 120 days after initial consultation. We evaluated PSM rates across the registry and their associations with patient and perioperative factors. Practice variation was also assessed. RESULTS: A total of 873 underwent PN. Median patient age was 59 years (IQR 49-67), tumor size 2.8 cm (22% T1b tumors), and RENL scores were 4-6 in 44%, 7-9 in 48%, and >=10 in 8.3%. A PSM was noted in 6.8% of patients. Clinical factors associated with PSM included BMI>=25 (p=0.049) and the endophytic component of the RENL score (p<0.01) There was a wide variation with regards to rates of PSM between practices (Figure). CONCLUSIONS: PSM rates for PN was associated with an increased BMI, and endophytic component of RENL score. There exists a wide practice variation in rates of PSM across the state of Michigan. Given this variation, there is a potential to learn technique from practices that are performing well in this metric. An international virtual workshop on techniques for avoiding PSM was conducted in October 2021. Factors driving this variation, including surgeon-specific factors and institutional factors (pathology protocols), need further investigation. Future QI projects planned include a video library of PN videos, and live peer-to-peer skills sessions. Source of Funding: Blue Cross Blue Shield of Michigan © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e275 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mohit Butaney More articles by this author Sonia Bhayani More articles by this author Ji Qi More articles by this author Anna Johnson More articles by this author Sara Perkins More articles by this author Sabrina Noyes More articles by this author Alon Weizer More articles by this author Lewis Johnson More articles by this author Amit Patel More articles by this author Alice Semerjian More articles by this author Brian Lane More articles by this author Craig Rogers More articles by this author for the Michigan Urological Surgery Improvement Collaborative More articles by this author Expand All Advertisement PDF DownloadLoading ...