MP84-15 NATIONAL TRENDS OF LOCAL ABLATIVE THERAPY AMONG YOUNG PATIENTS WITH SMALL RENAL MASSES

You have accessJournal of UrologyKidney Cancer: Surgical Therapy VII1 Apr 2015MP84-15 NATIONAL TRENDS OF LOCAL ABLATIVE THERAPY AMONG YOUNG PATIENTS WITH SMALL RENAL MASSES Jonathan E. Kiechle, Shan Dong, Robert Abouassaly, Hui Zhu, Edward E. Cherullo, Nilay D. Shah, Dean Nakamoto, Marc C. Smaldone, Matthew M. Cooney, and Simon P. Kim Jonathan E. KiechleJonathan E. Kiechle More articles by this author , Shan DongShan Dong More articles by this author , Robert AbouassalyRobert Abouassaly More articles by this author , Hui ZhuHui Zhu More articles by this author , Edward E. CherulloEdward E. Cherullo More articles by this author , Nilay D. ShahNilay D. Shah More articles by this author , Dean NakamotoDean Nakamoto More articles by this author , Marc C. SmaldoneMarc C. Smaldone More articles by this author , Matthew M. CooneyMatthew M. Cooney More articles by this author , and Simon P. KimSimon P. Kim More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1982AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Ablation of small renal masses (SRM's) has been shown to offer cancer control with limited follow-up. However, the long-term oncologic outcome remains uncertain. Although ablation is considered effective for patients with limited life expectancy, its use among younger patients may be considered controversial with limited long-term oncologic follow-up. Therefore, we sought to assess national trends in the local ablative therapy of SRM's in young patients. METHODS We used the National Cancer Database to identify all patients between the ages of 40 to 65 years old diagnosed with clinically localized T1a (< 4 cm) renal cell carcinoma (RCC) from 2004 to 2011. The primary outcome was the use of local ablative therapy to treat T1a renal masses. Multivariable logistic regression analysis was used to identify patient and hospital factors associated with ablation therapies in this patient cohort. RESULTS During the study period, we identified 49,441 patients with clinical T1a renal masses between the ages of 40-65 of which 2,789 (5.6%) were treated with primary ablative therapies. The proportion of patients undergoing ablation rose from 2.2% in 2004 to 6.2% in 2011 (p<0.001 for trend). On multivariable analysis, patients were more likely to undergo local ablation at academic hospitals (OR: 1.5; p<0.001) compared to community hospitals. Similarly, patients primarily insured by Medicaid (OR: 1.4; p<0.001) or Medicare (OR: 1.3; p<0.001) were more likely to undergo ablation compared to those with private insurance. CONCLUSIONS Use of local ablative therapies is gradually rising, but still used in a small fraction of patients with T1a RCC. Patients treated at high volume, academic hospitals or insured with Medicaid or Medicare were treated to a greater degree with ablation. These results have important implications about the dissemination of ablation and need for long-term oncologic follow-up data. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1064 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jonathan E. Kiechle More articles by this author Shan Dong More articles by this author Robert Abouassaly More articles by this author Hui Zhu More articles by this author Edward E. Cherullo More articles by this author Nilay D. Shah More articles by this author Dean Nakamoto More articles by this author Marc C. Smaldone More articles by this author Matthew M. Cooney More articles by this author Simon P. Kim More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...