PD49-09 COMPARATIVE ANALYSIS OF RENAL FUNCTIONAL OUTCOMES OF ACTIVE SURVEILLANCE AND PARTIAL NEPHRECTOMY IN THE MANAGEMENT OF ONCOCYTOMA: AN INTERNATIONAL MULTICENTER ANALYSIS

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy V (PD49)1 Apr 2020PD49-09 COMPARATIVE ANALYSIS OF RENAL FUNCTIONAL OUTCOMES OF ACTIVE SURVEILLANCE AND PARTIAL NEPHRECTOMY IN THE MANAGEMENT OF ONCOCYTOMA: AN INTERNATIONAL MULTICENTER ANALYSIS Margaret Meagher*, Brian Lane, Umberto Capitanio, Reza Mehrazin, Aaron Bradshaw, Sabrina Noyes, Alessandro Lacher, Ahmed Eldefrawy, Fady Ghali, Cathrine Keiner, Raksha Dutt, Nathan Miller, Jacob Bruinius, Devin Patel, Francesco Montorsi, and Ithaar Derweesh Margaret Meagher*Margaret Meagher* , Brian LaneBrian Lane , Umberto CapitanioUmberto Capitanio , Reza MehrazinReza Mehrazin , Aaron BradshawAaron Bradshaw , Sabrina NoyesSabrina Noyes , Alessandro LacherAlessandro Lacher , Ahmed EldefrawyAhmed Eldefrawy , Fady GhaliFady Ghali , Cathrine KeinerCathrine Keiner , Raksha DuttRaksha Dutt , Nathan MillerNathan Miller , Jacob BruiniusJacob Bruinius , Devin PatelDevin Patel , Francesco MontorsiFrancesco Montorsi , and Ithaar DerweeshIthaar Derweesh View All Author Informationhttps://doi.org/10.1097/JU.0000000000000943.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Active surveillance (AS) is a valid option for patients with small renal masses and in particular in the setting of benign neoplasms such as oncocytoma. We compared functional outcomes of partial nephrectomy (PN) and active surveillance (AS) in patients with oncocytoma. METHODS: Four-center (UC San Diego, Spectrum Health, Ospadele San Raffaele, Mt. Sinai) retrospective analysis of patients with oncocytoma managed with PN or AS. AS patients were diagnosed by percutaneous renal mass biopsy. Primary outcome development of de novo chronic kidney disease (CKD) stage 3 [estimated glomerular filtration rate<60 ml/min/1.73m2 (eGFR<60)]. Secondary outcome was ΔeGFR between diagnosis and last follow up. Multivariable analysis (MVA) was carried out for risk factors associated with development of de-novo CKD at last follow up. Linear regression was performed to elucidate factors associated with increasing ΔeGFR. Kaplan Meier Analysis (KMA) was used to analyze 5 year freedom from de novo CKD. RESULTS: 303 patients were analyzed (225 PN, 78 AS). No differences were noted between groups with respect to age (p=0.647), sex (p=1.000), HTN (p=0.78), DM (p=0.282), BMI (p=0.463), clinical tumor size (AS 2.5 vs. PN 2.9, p=0.056), or median follow-up time (AS 32 months vs. PN 38 months, p=0.251). Baseline RENAL scores did not differ significantly between groups (AS 7, PN 6, p=0.614). Mean change in tumor diameter during observation for AS was 0.3 cm. 7 patients (9%) in the AS group ultimately underwent surgical resection. Mean eGFR at diagnosis was similar (AS 78.2 vs. PN 76.9, p=0.653). ΔeGFR was greater for AS compared to PN (-14.73 vs. -6.48, p=0.002). MVA demonstrated increasing age (OR=1.03, p=0.048) and AS (OR 4.2, p<0.001) to be independently associated with development of de novo CKD. Linear regression analysis demonstrated that PN was associated with a smaller decrease in eGFR between diagnosis and last follow up (B=8.383, p =0.002). KMA revealed that 5-year freedom from CKD was significantly higher in PN compared to AS (86% vs. 59%, p<0.001; Figure). CONCLUSIONS: AS was associated with greater functional decline than PN in oncocytoma. Our findings support consideration of PN to optimalize renal functional preservation in oncocytoma when appropriate. Further investigation is requisite. Source of Funding: Stephen Weissman Kidney Cancer Research Fund © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1004-e1004 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Margaret Meagher* More articles by this author Brian Lane More articles by this author Umberto Capitanio More articles by this author Reza Mehrazin More articles by this author Aaron Bradshaw More articles by this author Sabrina Noyes More articles by this author Alessandro Lacher More articles by this author Ahmed Eldefrawy More articles by this author Fady Ghali More articles by this author Cathrine Keiner More articles by this author Raksha Dutt More articles by this author Nathan Miller More articles by this author Jacob Bruinius More articles by this author Devin Patel More articles by this author Francesco Montorsi More articles by this author Ithaar Derweesh More articles by this author Expand All Advertisement PDF downloadLoading ...