Mp28-02 consolidative nephrectomy after immunotherapy: operative characteristics and 90 day surgical outcomes

You have accessJournal of UrologyCME1 Apr 2023MP28-02 CONSOLIDATIVE NEPHRECTOMY AFTER IMMUNOTHERAPY: OPERATIVE CHARACTERISTICS AND 90 DAY SURGICAL OUTCOMES Stephen W. Reese, Lennert Eismann, Katiana Vazquez-Rivera, Arnold Oparanozie, Robert Motzer, Martin H. Voss, Chung-Han Lee, Ritesh R. Kotecha, Jonathan Coleman, Paul Russo, and A. Ari Hakimi Stephen W. ReeseStephen W. Reese More articles by this author , Lennert EismannLennert Eismann More articles by this author , Katiana Vazquez-RiveraKatiana Vazquez-Rivera More articles by this author , Arnold OparanozieArnold Oparanozie More articles by this author , Robert MotzerRobert Motzer More articles by this author , Martin H. VossMartin H. Voss More articles by this author , Chung-Han LeeChung-Han Lee More articles by this author , Ritesh R. KotechaRitesh R. Kotecha More articles by this author , Jonathan ColemanJonathan Coleman More articles by this author , Paul RussoPaul Russo More articles by this author , and A. Ari HakimiA. Ari Hakimi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003256.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The clinical and operative outcomes of patients undergoing consolidative nephrectomy after systemic immunotherapy is poorly characterized. Thus, we conducted a propensity matched analysis comparing the surgical outcomes after consolidative nephrectomy after systemic immunotherapy vs. patients who received upfront cytoreductive surgery. METHODS: In this single-institutional study from a large academic center, we retrospectively analyzed a cohort of patients undergoing surgery in the metastatic (M1) setting from 2015 to 2022. Propensity score matching via the nearest neighbor method was utilized to match patients who received pre-operative immunotherapy vs. upfront surgery based on clinical T-stage, surgical approach (open vs. robotic), gender, age and year of surgery. We identified peri-operative clinical characteristics and 90 day surgical complications, measured on the Clavien-Dindo scale, and quantified differences between the two groups. Group differences were compared using the Wilcoxon Rank-Sum test. RESULTS: After propensity score matching from a larger cohort of patients, 31 pts who received pre-operative systemic immunotherapy were matched to a similar cohort of 78 pts who underwent nephrectomy without pre-operative systemic therapy. Comparing patients who received systemic therapy prior to consolidative surgery vs. upfront surgery, most patients were clinical T-stage T3 or higher [22 (67.7%) vs. 55 (70.5%)], had clear cell histology [24 (80.8%) vs. 63 (77.4%)] and underwent an open surgical approach [18 (58.1%) vs. 55 (70.5%)]. There were no differences in operative duration, blood loos and median length of hospital stay, however the pre-operative immunotherapy group was more likely to be transfused >1u pRBC. There were no statistical differences between the two groups in terms of complications and most complications were minor complications (Clavien I-III) [9 (100.0%) vs. 57 (95.0%)]. The most common complications were infectious and respiratory. CONCLUSIONS: In our propensity score matched cohort, nephrectomy after systemic immunotherapy had similar operative characteristics and 90 day post-operative complications. Source of Funding: No funding © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e369 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Stephen W. Reese More articles by this author Lennert Eismann More articles by this author Katiana Vazquez-Rivera More articles by this author Arnold Oparanozie More articles by this author Robert Motzer More articles by this author Martin H. Voss More articles by this author Chung-Han Lee More articles by this author Ritesh R. Kotecha More articles by this author Jonathan Coleman More articles by this author Paul Russo More articles by this author A. Ari Hakimi More articles by this author Expand All Advertisement PDF downloadLoading ...