You have accessJournal of UrologyScience & Technology Posters1 Apr 2016S&T-02 PERCENTAGE OF RENAL PARENCHYMAL PRESERVATION AND RENAL TUMOR MORPHOLOGY ARE DETERMINANTS OF RENAL FUNCTIONAL OUTCOME FOLLOWING PERCUTANEOUS CRYOABLATION Catherine Dufour, Alp Beksac, Zachary Hamilton, Unwanaobong Nseyo, Sean Berquist, Abdel-rahman Hassan, Song Wang, Jason Woo, Gerant Rivera-Sanfeliz, Michael Liss, Robert Wake, and Ithaar Derweesh Catherine DufourCatherine Dufour More articles by this author , Alp BeksacAlp Beksac More articles by this author , Zachary HamiltonZachary Hamilton More articles by this author , Unwanaobong NseyoUnwanaobong Nseyo More articles by this author , Sean BerquistSean Berquist More articles by this author , Abdel-rahman HassanAbdel-rahman Hassan More articles by this author , Song WangSong Wang More articles by this author , Jason WooJason Woo More articles by this author , Gerant Rivera-SanfelizGerant Rivera-Sanfeliz More articles by this author , Michael LissMichael Liss More articles by this author , Robert WakeRobert Wake More articles by this author , and Ithaar DerweeshIthaar Derweesh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2831AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Percutaneous renal cryoablation (PRC) is an option for management of small renal mass (SRM). We investigated renal functional outcomes in PRC focusing on percent parenchyma spared and RENAL nephrometry score as a measure of tumor morphology. METHODS Multicenter retrospective analysis of patients who underwent PRC for SRM from 09/2005-08/2014. A cut off of 25% decrease (6 months post procedure-pre procdure) in estimated glomerular filtration rate (eGFR, MDRD) was utilized as a surrogate for significant renal functional decline. We divided the cohort into patients who had >25% and ≤25% decline in eGFR post PRC. RENAL score was assigned to all tumors. Percent parenchymal preservation (PPP) was calculated with 3-dimensional imaging. Demographic, perioperative factors, RENAL score, and PPP were analyzed between the two groups. Multivariable analysis (MVA) was performed to identify risk factors associated with renal functional decline. RESULTS 153 patients [23.5% (36 with >25% decline)/76.5% (117 with ≤25% decline); median follow up 48 months] were analyzed. More female (63.9% vs. 28.2%, p=0.0001) and diabetic (41.7% vs. 26.2%, p=0.021) patients had decrease of eGFR>25%. Median tumor size was significantly higher in the >25% eGFR decrease (2.8 vs. 2.4 cm, p=0.005) as was median RENAL score (7 vs. 5, p<0.001). Complication rates were not significantly different (p=0.079). Significantly less PPP (70% vs. 85%, p<0.0001) and higher median number of probes (3 vs. 2, p<0.001) were noted in >25% eGFR decline group. MVA demonstrated decreasing PPP (OR 1.4, p<0.0001), increasing RENAL score (OR 2.41, p=0.004) and female sex (OR 7.18, p=0.013) as independent risk factors for decrease in eGFR >25%. CONCLUSIONS Absence of global renal ischemic insult does not protect the kidney from renal functional decline and a significant proportion of patients may yet go on to suffer significant decreases in GFR. Increasing tumor complexity and decreasing percentage parenchyma spared and female sex were independently associated with significant renal functional decline. Development of predictive computer modeling to aid in optimal patient selection and procedure planning may aid in optimizing renal functional outcomes. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e308-e309 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Catherine Dufour More articles by this author Alp Beksac More articles by this author Zachary Hamilton More articles by this author Unwanaobong Nseyo More articles by this author Sean Berquist More articles by this author Abdel-rahman Hassan More articles by this author Song Wang More articles by this author Jason Woo More articles by this author Gerant Rivera-Sanfeliz More articles by this author Michael Liss More articles by this author Robert Wake More articles by this author Ithaar Derweesh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...