Pd18-12 Outcomes of Minimally Invasive Nephrectomy Following Immune-Checkpoint Inhibitor Therapy: Data From a Multicenter Study

You have accessJournal of UrologyKidney Cancer: Advanced (Including Drug Therapy) II (PD18)1 May 2024PD18-12 OUTCOMES OF MINIMALLY INVASIVE NEPHRECTOMY FOLLOWING IMMUNE-CHECKPOINT INHIBITOR THERAPY: DATA FROM A MULTICENTER STUDY Alireza Ghoreifi, Farshad Sheybaee Moghaddam, Stephan Bronimann, Thomas Gerald, Emma K. Helstrom, Ekam S. Deol, Sina Sobhani, Inderbir Gill, R. Houston Thompson, Robert Uzzo, Abhinav Khanna, Randall Lee, Vitaly Margulis, Nirmish Singla, and Hooman Djaladat Alireza GhoreifiAlireza Ghoreifi , Farshad Sheybaee MoghaddamFarshad Sheybaee Moghaddam , Stephan BronimannStephan Bronimann , Thomas GeraldThomas Gerald , Emma K. HelstromEmma K. Helstrom , Ekam S. DeolEkam S. Deol , Sina SobhaniSina Sobhani , Inderbir GillInderbir Gill , R. Houston ThompsonR. Houston Thompson , Robert UzzoRobert Uzzo , Abhinav KhannaAbhinav Khanna , Randall LeeRandall Lee , Vitaly MargulisVitaly Margulis , Nirmish SinglaNirmish Singla , and Hooman DjaladatHooman Djaladat View All Author Informationhttps://doi.org/10.1097/01.JU.0001008596.32809.c5.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is high-level evidence supporting the use of immune checkpoint inhibitors (ICIs) in advanced renal cell carcinoma (RCC); however, limited data is available regarding nephrectomy, especially through a minimally invasive (MIS) approach, in this setting. The aim of this study is to report the outcomes of MIS nephrectomy following ICI therapy. METHODS: Using our IRB-approved multicenter data registry, we included patients with advanced RCC who underwent nephrectomy following ICI therapy at five high-volume US academic centers between 2015 and 2023. Clinical features and perioperative outcomes of those who underwent MIS approach were reviewed. Multivariable logistic regression was performed to evaluate the factors influencing the choice between MIS and open approach. RESULTS: A total of 158 patients were included, of whom 76 and 82 underwent MIS and open nephrectomies, respectively. Baseline clinical features of patients are shown in Table 1. The MIS procedures included robotic (n=56) and laparoscopic (n=20). A total of 6 (8%) patients converted to open (4 robotic and 2 lap) due to pancreatic injury (n=1), vascular injury (n=1), and failure to progress (n=4). On multivariable analysis, patients with non-metastatic vs. metastatic RCC (HR 3.1, 95%CI 1.3–7.3, p=0.01), those with smaller tumor size (HR 1.2 for each cm, 95%CI 1.1–1.3, p=0.001) and no clinical evidence of inferior vena cava thrombus (HR 29, 95% CI 3.5–237.4, p=0.002) were more likely to undergo MIS compared to open approach. Perioperative outcomes of MIS nephrectomies are shown in Figure 1. The 90-day complication and readmission rates were 22% (Clavien≥3: 8%) and 9%, respectively. No 90-day mortality was reported. CONCLUSIONS: Minimally invasive approach appears safe in properly selected patients with advanced renal cell carcinoma who are candidates for nephrectomy following ICI therapy. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e437 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Alireza Ghoreifi More articles by this author Farshad Sheybaee Moghaddam More articles by this author Stephan Bronimann More articles by this author Thomas Gerald More articles by this author Emma K. Helstrom More articles by this author Ekam S. Deol More articles by this author Sina Sobhani More articles by this author Inderbir Gill More articles by this author R. Houston Thompson More articles by this author Robert Uzzo More articles by this author Abhinav Khanna More articles by this author Randall Lee More articles by this author Vitaly Margulis More articles by this author Nirmish Singla More articles by this author Hooman Djaladat More articles by this author Expand All Advertisement PDF downloadLoading ...