Pd11-01 Trends and Costs of Minimally Invasive Renal Surgery for Kidney Cancer: A National Population-Based Study

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy I (PD11) 1 May 2024PD11-01 TRENDS AND COSTS OF MINIMALLY INVASIVE RENAL SURGERY FOR KIDNEY CANCER: A NATIONAL POPULATION-BASED STUDY Francesco Ditonno, Antonio Franco, Celeste Manfredi, Leslie Claire Licari, Eugenio Bologna, Morgan R. Sturgis, Carol L. Feng, Marco De Sio, Cosimo De Nunzio, Alessandro Antonelli, Srinivas Vourganti, Edward E. Cherullo, Ithaar H. Derweesh, Ephrem E. Olweny, and Riccardo Autorino Francesco DitonnoFrancesco Ditonno, Antonio FrancoAntonio Franco, Celeste ManfrediCeleste Manfredi, Leslie Claire LicariLeslie Claire Licari, Eugenio BolognaEugenio Bologna, Morgan R. SturgisMorgan R. Sturgis, Carol L. FengCarol L. Feng, Marco De SioMarco De Sio, Cosimo De NunzioCosimo De Nunzio, Alessandro AntonelliAlessandro Antonelli, Srinivas VourgantiSrinivas Vourganti, Edward E. CherulloEdward E. Cherullo, Ithaar H. DerweeshIthaar H. Derweesh, Ephrem E. OlwenyEphrem E. Olweny, and Riccardo AutorinoRiccardo Autorino View All Author Informationhttps: //doi. org/10. 1097/01. JU. 0001008604. 95535. b9. 01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Evidence regarding surgical trends and utilization of minimally invasive renal surgery (MIRS) for kidney cancer across different socioeconomic groups and regions of the United States are limited. The aim of the present study was to investigate temporal trends and costs of MIRS for kidney cancer, an evaluation of overall complication rates across treatment modalities, and the impact of social determinants of health (SDOH) on postoperative outcomes. METHODS: The PearlDiver Mariner, a national database of insurance billing records, was queried for this retrospective observational cohort analysis. The study population was identified and stratified according to treatment modality into minimally invasive partial nephrectomy (MIPN), minimally invasive radical nephrectomy (MIRN), and renal ablation (RA). Overall complications were defined as adverse events within 60 days after discharge. Temporal analysis of surgical trends involved negative binomial regression to evaluate the overall number of MIRS and Cochran-Armitage tests to compare the utilization of different treatment modalities. Multivariable logistic regression analysis was conducted to identify predictors of perioperative complications. RESULTS: A total of 80, 821 patients undergoing MIRS for kidney cancer were identified. Most patients were privately insured (55, 397, 68. 5%), and SDOH were present in 6, 622 (8. 2%) patients. Over the study period, MIPN (slope of regression line, reg. =0. 026, p<. 001) as a fraction of total MIRS increased significantly, while proportions for MIRN (reg. =-0. 020, p<0. 001) and RA (reg. =-0. 003, p<0. 001) decreased accordingly. No significant difference was observed in terms of number of complications (p=. 06) and presence of SDOH (p=. 07) among the different groups. MIRN (26, 9k±40, 9k) and RA (18, 9k±31, 6k) were the most expensive and the cheapest procedure, respectively. Per patient average expenses for MIPN were 21, 4k±32, 5k. At multivariable analysis, SDOH patients had higher odds of experiencing postoperative complications. Patients undergoing RA had a significantly lower probability of perioperative complications when MIPN (OR 0. 89, 95% CI 0. 83-0. 96) or MIRN (OR 0. 80, 95% CI 0. 74-0. 87) were used as a reference. MIRN was a significant predictor of complications compared to MIPN (OR 1. 14, 95% CI 1. 08-1. 21) and RA (OR 1. 2, 95% CI 1. 13-1. 26). CONCLUSIONS: This study provides a description of the current management of kidney cancer, delving beyond the clinical aspects, to offer a socioeconomic perspective on the impact of this disease in everyday clinical practice. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc. FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e249 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc. Metrics Author Information Francesco Ditonno More articles by this author Antonio Franco More articles by this author Celeste Manfredi More articles by this author Leslie Claire Licari More articles by this author Eugenio Bologna More articles by this author Morgan R. Sturgis More articles by this author Carol L. Feng More articles by this author Marco De Sio More articles by this author Cosimo De Nunzio More articles by this author Alessandro Antonelli More articles by this author Srinivas Vourganti More articles by this author Edward E. Cherullo More articles by this author Ithaar H. Derweesh More articles by this author Ephrem E. Olweny More articles by this author Riccardo Autorino More articles by this author Expand All Advertisement PDF downloadLoading. . .