Pd33-03 Assessing Functional Outcomes of Partial Versus Radical Nephrectomy for T1b-T2 Renal Masses: Results From a Multi-Institutional Collaboration

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy II (PD33)1 May 2024PD33-03 ASSESSING FUNCTIONAL OUTCOMES OF PARTIAL VERSUS RADICAL NEPHRECTOMY FOR T1B-T2 RENAL MASSES: RESULTS FROM A MULTI-INSTITUTIONAL COLLABORATION Stefano Tappero, Paolo Dell'Oglio, Riccardo Campi, Riccardo Bertolo, Marco Roscigno, Angela Pecoraro, Giuseppe Simone, Nazareno Suardi, Riccardo Schiavina, Karim Bensalah, Erdem Canda, Xu Zhang, Carlo Terrone, Shahrokh Shariat, Francesco Porpiglia, Alessandro Antonelli, Jihad Kaouk, Ketan Badani, Andrea Minervini, Ithaar Derweesh, Alberto Breda, Alexandre Mottrie, Francesco Montorsi, and Carlo Andrea Bravi Stefano TapperoStefano Tappero , Paolo Dell'OglioPaolo Dell'Oglio , Riccardo CampiRiccardo Campi , Riccardo BertoloRiccardo Bertolo , Marco RoscignoMarco Roscigno , Angela PecoraroAngela Pecoraro , Giuseppe SimoneGiuseppe Simone , Nazareno SuardiNazareno Suardi , Riccardo SchiavinaRiccardo Schiavina , Karim BensalahKarim Bensalah , Erdem CandaErdem Canda , Xu ZhangXu Zhang , Carlo TerroneCarlo Terrone , Shahrokh ShariatShahrokh Shariat , Francesco PorpigliaFrancesco Porpiglia , Alessandro AntonelliAlessandro Antonelli , Jihad KaoukJihad Kaouk , Ketan BadaniKetan Badani , Andrea MinerviniAndrea Minervini , Ithaar DerweeshIthaar Derweesh , Alberto BredaAlberto Breda , Alexandre MottrieAlexandre Mottrie , Francesco MontorsiFrancesco Montorsi , and Carlo Andrea BraviCarlo Andrea Bravi View All Author Informationhttps://doi.org/10.1097/01.JU.0001008912.25331.d7.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Renal function deterioration following kidney surgery is associated with increased all-cause mortality. In patients with renal masses>4 cm, whether partial vs radical nephrectomy (PN vs RN) might affect long-term functional outcomes is unknown. The current study aims to test the association between type of surgery (PN vs RN) and: (a). post-operative acute kidney injury (AKI); (b). recovery of ≥90% preoperative eGFR one year after surgery; (c) upstaging ≥1 CKD stage at one year as compared to preoperative stage; (d) eGFR decline ≤45 ml/min/1.73 m2 one-year after surgery. METHODS: A collaborative database including patients' data from 23 high-volume European institutions was exploited. Only surgically-treated patients with single, unilateral, clinical T1b-2 renal masses, with no evidence of systemic disease, were included. Multivariable logistic regression analyses addressed the outcomes of interest; clinical stage-specific sensitivity analyses (cT1b and cT2) were performed. RESULTS: Overall, 968 vs 325 patients treated with PN vs RN were identified. The rate of AKI was lower in PN vs RN patients (17% vs 58%, p<0.001). One year after surgery, in PN vs RN patients respectively, the rate of recovery of ≥90% of baseline eGFR was 51% vs 16%, the rate of CKD progression of ≥1 stage was 38% vs 65%, and the rate of eGFR decline ≤45 ml/min/1.73 m2 was 10% vs 23% (all p values<0.001). RN reached the independent unfavorable predictor status of all the outcomes of interest: (a). AKI, odds ratio (OR): 7.61; (b). one-year ≥90% eGFR recovery, OR: 0.30; (c). one-year CKD upstaging, OR: 1.78; (d). one-year eGFR decline ≤45 ml/min/1.73 m2, OR: 2.36 (all p-values≤0.002). Virtually the same results were observed in sensitivity analyses specifically addressing cT1b, and subsequently cT2 renal masses, separately. The retrospective nature of the employed data represented the foremost limitation. CONCLUSIONS: In patients with cT1b-2 renal masses, our data suggests that RN might portend worse immediate, as well as one-year functional outcomes. When technically feasible, in case of large renal masses, efforts should be made to preserve the healthy kidney tissue, as this might restrain the likelihood of metabolic and cardiovascular sequele associated to glomerular function loss. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e710 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Stefano Tappero More articles by this author Paolo Dell'Oglio More articles by this author Riccardo Campi More articles by this author Riccardo Bertolo More articles by this author Marco Roscigno More articles by this author Angela Pecoraro More articles by this author Giuseppe Simone More articles by this author Nazareno Suardi More articles by this author Riccardo Schiavina More articles by this author Karim Bensalah More articles by this author Erdem Canda More articles by this author Xu Zhang More articles by this author Carlo Terrone More articles by this author Shahrokh Shariat More articles by this author Francesco Porpiglia More articles by this author Alessandro Antonelli More articles by this author Jihad Kaouk More articles by this author Ketan Badani More articles by this author Andrea Minervini More articles by this author Ithaar Derweesh More articles by this author Alberto Breda More articles by this author Alexandre Mottrie More articles by this author Francesco Montorsi More articles by this author Carlo Andrea Bravi More articles by this author Expand All Advertisement PDF downloadLoading ...