MP51-10 FUNCTIONAL OUTCOMES IN RENAL MASS PATIENTS UNDERGOING ACTIVE SURVEILLANCE VERSUS PARTIAL NEPHRECTOMY: A PROPENSITY SCORE MATCHED ANALYSIS

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging/Surveillance II (MP51)1 May 2024MP51-10 FUNCTIONAL OUTCOMES IN RENAL MASS PATIENTS UNDERGOING ACTIVE SURVEILLANCE VERSUS PARTIAL NEPHRECTOMY: A PROPENSITY SCORE MATCHED ANALYSIS Mimi V. Nguyen, Brian Lane, Kit L. Yuen, Cesare Saitta, Yasuhisa Fujii, Edouard Nicaise, Clara Cerrato, Dhruv Puri, Margaret Meagher, Jacob Roberts, Jonathan A. Afari, Dattatraya Patil, Kobayashi Masaki, Kazutaka Saito, Fukuda Shohei, Dennis Boynton, Sabrina Noyes, Hajime Tanaka, Viraj Master, Ithaar H. Derweesh, and Juan Javier Desloges Mimi V. NguyenMimi V. Nguyen , Brian LaneBrian Lane , Kit L. YuenKit L. Yuen , Cesare SaittaCesare Saitta , Yasuhisa FujiiYasuhisa Fujii , Edouard NicaiseEdouard Nicaise , Clara CerratoClara Cerrato , Dhruv PuriDhruv Puri , Margaret MeagherMargaret Meagher , Jacob RobertsJacob Roberts , Jonathan A. AfariJonathan A. Afari , Dattatraya PatilDattatraya Patil , Kobayashi MasakiKobayashi Masaki , Kazutaka SaitoKazutaka Saito , Fukuda ShoheiFukuda Shohei , Dennis BoyntonDennis Boynton , Sabrina NoyesSabrina Noyes , Hajime TanakaHajime Tanaka , Viraj MasterViraj Master , Ithaar H. DerweeshIthaar H. Derweesh , and Juan Javier DeslogesJuan Javier Desloges View All Author Informationhttps://doi.org/10.1097/01.JU.0001009492.49624.4b.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Management of localized renal masses presents a complex decision-making process, particularly when weighing the benefits of active surveillance (AS) against surgical intervention. We utilized propensity score matching (PSM) to compare renal functional outcomes of partial nephrectomy (PN) and AS, focusing decline to thresholds of moderate and severe chronic kidney disease (CKD). METHODS: This was a retrospective analysis of patients who underwent AS or PN for localized renal masses. PSM was utilized to generate patient cohorts based on treatment type (AS vs PN) matched for age, HTN, DM, and tumor size. Primary outcome was development of de novo CKD 3b [estimated glomerular filtration rate (eGFR) <45 mL/min/1.73 m2]. Secondary outcomes included development of de novo CKD 3a (eGFR <60) and de novo CKD 4 (eGFR <30). Multivariable Cox regression analysis (MVA) identified risk factors for renal functional decline. Kaplan-Meier analysis (KMA) evaluated functional decline to CKD 3a, 3b, and CKD 4 thresholds based on treatment type. RESULTS: We analyzed 704 patients (352 AS vs 352 PN; median follow up 48 months). Increasing BMI (HR 1.04, p=0.014), male gender (HR 2.90, p<0.001), increasing age (HR 1.08, p<0.001), and PN (HR 2.19, p<0.001) as independent risk factors for denovo CKD 3b. Decreasing baseline eGFR (HR 1.02, p<0.001), increasing BMI (HR 1.03, p=0.02), male gender (HR 2.8, p<0.001), increasing age (HR 1.06, p<0.001), and PN (HR 1.7, p=0.004) as independent risk factors for denovo CKD 3a. Increasing BMI (HR 1.08, p=0.001), decreasing baseline eGFR (HR 1.98, p=0.009), increasing age (HR 1.09, p<0.001) were independent risk factors for denovo CKD 4, while type of management was not (p=0.407). KMA (Figure 1) comparing PN and AS demonstrated worsened 5-year freedom from denovo CKD3b (71% vs AS 84%, p=0.006) and denovo CKD 3a (PN 87% vs. AS 92%, p=0.201) but not CKD 4 (PN 89% vs. AS 94%, p=0.200). CONCLUSIONS: In a PSM matched cohort with intermediate term follow up, PN was an independent risk factor and associated with worse freedom for decline to CKD-3a and CKD-3b thresholds. Our data support consideration of AS as a primary option in patients with low-risk neoplasms in whom functional preservation is a priority. Download PPT Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e845 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Mimi V. Nguyen More articles by this author Brian Lane More articles by this author Kit L. Yuen More articles by this author Cesare Saitta More articles by this author Yasuhisa Fujii More articles by this author Edouard Nicaise More articles by this author Clara Cerrato More articles by this author Dhruv Puri More articles by this author Margaret Meagher More articles by this author Jacob Roberts More articles by this author Jonathan A. Afari More articles by this author Dattatraya Patil More articles by this author Kobayashi Masaki More articles by this author Kazutaka Saito More articles by this author Fukuda Shohei More articles by this author Dennis Boynton More articles by this author Sabrina Noyes More articles by this author Hajime Tanaka More articles by this author Viraj Master More articles by this author Ithaar H. Derweesh More articles by this author Juan Javier Desloges More articles by this author Expand All Advertisement PDF downloadLoading ...