MP59-20 COMPARATIVE ANALYSIS OF MINIMALLY INVASIVE RADICAL AND PARTIAL NEPHRECTOMY FOR CLINICAL T2 RENAL MASS: ANALYSIS OF THE ROBOTIC SURGERY FOR LARGE RENAL MASS (ROSULA) GROUP

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy VI1 Apr 2018MP59-20 COMPARATIVE ANALYSIS OF MINIMALLY INVASIVE RADICAL AND PARTIAL NEPHRECTOMY FOR CLINICAL T2 RENAL MASS: ANALYSIS OF THE ROBOTIC SURGERY FOR LARGE RENAL MASS (ROSULA) GROUP Ahmet Bindayi, Zachary Hamilton, Stephen Ryan, Giuseppe Simone, Michele Gallucci, Madhumitha Reddy, Gabriele Tuderti, Kendrick Yim, Manuela Costantini, Andrea Minervini, Andrea Mari, Marco Carini, Daniel Eun, Koon Rha, Bo Yang, Francesco Montorsi, Alexandre Mottrie, Alessandro Larcher, Umberto Capitanio, Aryeh Keehn, Francesco Porpiglia, Ricacardo Bertolo, Robert Uzzo, Sisto Perdona, Giuseppe Quarto, James Porter, Michael Liao, Matteo Ferro, Ottavio De Cobelli, Geert De Naeyer, Kidon Chang, Alexander Kutikov, David Chen, Marc Smaldone, Luigi Schips, Francesco Berardinelli, Wesley White, Chao Zang, Ken Jacobsohn, Peter Langenstroer, Peter Dietrich, Prokar Dasgupta, Nicole de Luyk, Ben Challacombe, Uzoma Anele, Lance Hampton, Clayton Lau, Patrick Kilday, Chandru Sundaram, Jay Sulek, Riccardo Autorino, and Ithaar Derweesh Ahmet BindayiAhmet Bindayi More articles by this author , Zachary HamiltonZachary Hamilton More articles by this author , Stephen RyanStephen Ryan More articles by this author , Giuseppe SimoneGiuseppe Simone More articles by this author , Michele GallucciMichele Gallucci More articles by this author , Madhumitha ReddyMadhumitha Reddy More articles by this author , Gabriele TudertiGabriele Tuderti More articles by this author , Kendrick YimKendrick Yim More articles by this author , Manuela CostantiniManuela Costantini More articles by this author , Andrea MinerviniAndrea Minervini More articles by this author , Andrea MariAndrea Mari More articles by this author , Marco CariniMarco Carini More articles by this author , Daniel EunDaniel Eun More articles by this author , Koon RhaKoon Rha More articles by this author , Bo YangBo Yang More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , Alexandre MottrieAlexandre Mottrie More articles by this author , Alessandro LarcherAlessandro Larcher More articles by this author , Umberto CapitanioUmberto Capitanio More articles by this author , Aryeh KeehnAryeh Keehn More articles by this author , Francesco PorpigliaFrancesco Porpiglia More articles by this author , Ricacardo BertoloRicacardo Bertolo More articles by this author , Robert UzzoRobert Uzzo More articles by this author , Sisto PerdonaSisto Perdona More articles by this author , Giuseppe QuartoGiuseppe Quarto More articles by this author , James PorterJames Porter More articles by this author , Michael LiaoMichael Liao More articles by this author , Matteo FerroMatteo Ferro More articles by this author , Ottavio De CobelliOttavio De Cobelli More articles by this author , Geert De NaeyerGeert De Naeyer More articles by this author , Kidon ChangKidon Chang More articles by this author , Alexander KutikovAlexander Kutikov More articles by this author , David ChenDavid Chen More articles by this author , Marc SmaldoneMarc Smaldone More articles by this author , Luigi SchipsLuigi Schips More articles by this author , Francesco BerardinelliFrancesco Berardinelli More articles by this author , Wesley WhiteWesley White More articles by this author , Chao ZangChao Zang More articles by this author , Ken JacobsohnKen Jacobsohn More articles by this author , Peter LangenstroerPeter Langenstroer More articles by this author , Peter DietrichPeter Dietrich More articles by this author , Prokar DasguptaProkar Dasgupta More articles by this author , Nicole de LuykNicole de Luyk More articles by this author , Ben ChallacombeBen Challacombe More articles by this author , Uzoma AneleUzoma Anele More articles by this author , Lance HamptonLance Hampton More articles by this author , Clayton LauClayton Lau More articles by this author , Patrick KildayPatrick Kilday More articles by this author , Chandru SundaramChandru Sundaram More articles by this author , Jay SulekJay Sulek More articles by this author , Riccardo AutorinoRiccardo Autorino More articles by this author , and Ithaar DerweeshIthaar Derweesh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1872AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Utilization of partial nephrectomy (PN) for clinical T2 renal mass (cT2RM) is controversial. Minimally invasive surgery (MIS) is increasingly used in larger masses, though impact of MIS in cT2RM is unclear. We compared outcomes of MIS PN and radical nephrectomy (RN) in cT2RM. METHODS Retrospective international multicenter analysis of MIS PN and RN for cT2RM (T2N0M0) [RObotic SUrgery for LArge renal mass (ROSULA) Group]. Primary outcome was change in estimated glomerular filtration rate (ΔeGFR). Secondary outcomes included complication rates, de novo Chronic Kidney Disease (CKD, eGFR<60 mL/min/1.73m2) and eGFR<45, overall survival (OS) and progression free survival (PFS). Multivariable analysis (MVA) and Kaplan-Meier analysis (KMA) were carried out for survival and de novo eGFR<45. RESULTS 847 patients (201 PN/633 RN, median follow up 20 months) were analyzed. RN had larger tumor size (9.2 vs. 8.5 cm, p<0.001) and RENAL score (9.5 vs. 9, p=0.001). Median ischemia time for PN was 22 minutes. No significant differences were noted for 30 day complications (PN 24% vs. RN 17.9%, p=0.1) or readmissions (p=0.1). PN had higher estimated blood loss (230 mL vs. 174 mL, p=0.034) and positive margin rate (7.8% vs. RN 3.6%, p=0.028). PN had lower ΔeGFR (9.2 vs 30, p<0.001) de novo CKD (14.7% vs. 55.6%, p<0.001) and de novo eGFR <45 (4.1% vs. 32.3%, p<0.001). MVA revealed that increasing ASA (American Society of Anesthesiologists) score (HR 5.83, p<0.001) was predictive for all cause mortality, but not type of surgery (p=0.29). Increasing age (HR 1.07, p <0.001) and RN (HR 13.5, p <0.001) were independent predictors for de novo eGFR<45. KMA showed 87% and 82% 5-year OS for patients who underwent PN and RN, respectively (p =0.189) No significant differences were noted for 5 year PFS (PN 82.5% vs. RN 70%, p<0.064). CONCLUSIONS MIS PN for select cT2RM provides renal functional benefit while not compromising oncologic and outcomes and not having greater morbidity. Consideration may be given to PN in cT2RM when technically feasible and indicated. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e789 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Ahmet Bindayi More articles by this author Zachary Hamilton More articles by this author Stephen Ryan More articles by this author Giuseppe Simone More articles by this author Michele Gallucci More articles by this author Madhumitha Reddy More articles by this author Gabriele Tuderti More articles by this author Kendrick Yim More articles by this author Manuela Costantini More articles by this author Andrea Minervini More articles by this author Andrea Mari More articles by this author Marco Carini More articles by this author Daniel Eun More articles by this author Koon Rha More articles by this author Bo Yang More articles by this author Francesco Montorsi More articles by this author Alexandre Mottrie More articles by this author Alessandro Larcher More articles by this author Umberto Capitanio More articles by this author Aryeh Keehn More articles by this author Francesco Porpiglia More articles by this author Ricacardo Bertolo More articles by this author Robert Uzzo More articles by this author Sisto Perdona More articles by this author Giuseppe Quarto More articles by this author James Porter More articles by this author Michael Liao More articles by this author Matteo Ferro More articles by this author Ottavio De Cobelli More articles by this author Geert De Naeyer More articles by this author Kidon Chang More articles by this author Alexander Kutikov More articles by this author David Chen More articles by this author Marc Smaldone More articles by this author Luigi Schips More articles by this author Francesco Berardinelli More articles by this author Wesley White More articles by this author Chao Zang More articles by this author Ken Jacobsohn More articles by this author Peter Langenstroer More articles by this author Peter Dietrich More articles by this author Prokar Dasgupta More articles by this author Nicole de Luyk More articles by this author Ben Challacombe More articles by this author Uzoma Anele More articles by this author Lance Hampton More articles by this author Clayton Lau More articles by this author Patrick Kilday More articles by this author Chandru Sundaram More articles by this author Jay Sulek More articles by this author Riccardo Autorino More articles by this author Ithaar Derweesh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...