Impact of benign histology on perioperative complication and functional outcomes of robot assisted partial nephrectomy

You have accessJournal of UrologyCME1 Apr 2023MP58-17 IMPACT OF BENIGN HISTOLOGY ON PERIOPERATIVE COMPLICATION AND FUNCTIONAL OUTCOMES OF ROBOT ASSISTED PARTIAL NEPHRECTOMY Rocco Simone Flammia, Umberto Anceschi, Aldo Brassetti, Mariaconsiglia Ferriero, Riccardo Mastroianni, Leonardo Misuraca, Gabriele Tuderti, Antonio Tufano, Salvatore Guaglianone, Costantino Leonardo, Michele Gallucci, Porpiglia Francesco, Daniele Amparore, Andrea Minervini, Andrea Mari, Andre Antonio Grasso, Ithaar Derweesh, Riccardo Autorino, Daniel Eun, Alessandro Larcher, Umberto Capitanio, Carlo Andrea Bravi, Alexander Mottrie, Aalst, Belgium, and Giuseppe Simone Rocco Simone FlammiaRocco Simone Flammia More articles by this author , Umberto AnceschiUmberto Anceschi More articles by this author , Aldo BrassettiAldo Brassetti More articles by this author , Mariaconsiglia FerrieroMariaconsiglia Ferriero More articles by this author , Riccardo MastroianniRiccardo Mastroianni More articles by this author , Leonardo MisuracaLeonardo Misuraca More articles by this author , Gabriele TudertiGabriele Tuderti More articles by this author , Antonio TufanoAntonio Tufano More articles by this author , Salvatore GuaglianoneSalvatore Guaglianone More articles by this author , Costantino LeonardoCostantino Leonardo More articles by this author , Michele GallucciMichele Gallucci More articles by this author , Porpiglia FrancescoPorpiglia Francesco More articles by this author , Daniele AmparoreDaniele Amparore More articles by this author , Andrea MinerviniAndrea Minervini More articles by this author , Andrea MariAndrea Mari More articles by this author , Andre Antonio GrassoAndre Antonio Grasso More articles by this author , Ithaar DerweeshIthaar Derweesh More articles by this author , Riccardo AutorinoRiccardo Autorino More articles by this author , Daniel EunDaniel Eun More articles by this author , Alessandro LarcherAlessandro Larcher More articles by this author , Umberto CapitanioUmberto Capitanio More articles by this author , Carlo Andrea BraviCarlo Andrea Bravi More articles by this author , Alexander MottrieAlexander Mottrie More articles by this author , Aalst Aalst More articles by this author , Belgium Belgium More articles by this author , and Giuseppe SimoneGiuseppe Simone More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003311.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Partial nephrectomy (PN) represents the standard of care for localized kidney tumor. Nonetheless, a proportion of PN treated patients harbor benign histology (Bn) at final pathology report. Moreover, the contemporary surge in incidental diagnosis of renal masses may inadvertently increase the overall number of patients treated with PN for Bn lesion. Unfortunately, literature specifically addressing Bn tumors is scarce. To address this void, we investigated contemporary rates of Bn histology, as well as perioperative and functional outcomes of RAPN performed for Bn tumors. METHODS: Whitin a multi-institutional database, we identified North American and European patients aged >18 years old treated with RAPN for localized renal masses (cT1-2). Then, 1:1 PSM between malignant (Mn) vs Bn histology was performed adjusting for important confounders (age, sex, WIT, baseline eGFR, RENAL, BMI, ASA, Hypertension, Diabetes, solitary kidney status and multifocality). Cox regression model addressed any upstaging to CKD ≥ 3a (CKD3a-upstaging) and to CKD ≥3b (CKD3b-upstaging), linear model addressed length of hospital stay (LOS) and logistic regression model addressed any perioperative complications and postoperative Acute Kidney Injury (AKI). RESULTS: Overall, 2256 patients were identified. Of those, 530 (23%) harbored Bn. The majority were oncocytoma (47.1%) followed by angiomyolipoma (39.4%). Baseline characteristics, perioperative and funcitonal outcomes were reported in Table 1. After PSM, no differences in CKD3a-upstaging (HR: 1.26 95%CI 0.87-1.81, p=0.2), CKD3b-upstaging (HR: 1.04 95%CI 0.57-1.91, p=0.9), LOS (estimate: -0.22±0.21, p=0.3), any complications (OR: 1.14 95%CI 0.70 – 1.90, p=0.6) and postoperative AKI (OR: 0.97 95%CI 0.60 – 1.57, p=0.9) between Bn vs Mn were detected. CONCLUSIONS: Overall, more than one fifth of patients receiving RAPN for localized renal masses harbored Bn with a tiny percentage exhibiting high-grade complications. Despite accurate adjustments, Bn patients did not exhibit better outcomes than their Mn counterparts. Thus, these data are of primary importance when counseling patients treated with RAPN for Bn renal masses and questioned the benefit of RAPN as all-in-one strategy for diagnosis and treatment in those patients. Source of Funding: no © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e803 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rocco Simone Flammia More articles by this author Umberto Anceschi More articles by this author Aldo Brassetti More articles by this author Mariaconsiglia Ferriero More articles by this author Riccardo Mastroianni More articles by this author Leonardo Misuraca More articles by this author Gabriele Tuderti More articles by this author Antonio Tufano More articles by this author Salvatore Guaglianone More articles by this author Costantino Leonardo More articles by this author Michele Gallucci More articles by this author Porpiglia Francesco More articles by this author Daniele Amparore More articles by this author Andrea Minervini More articles by this author Andrea Mari More articles by this author Andre Antonio Grasso More articles by this author Ithaar Derweesh More articles by this author Riccardo Autorino More articles by this author Daniel Eun More articles by this author Alessandro Larcher More articles by this author Umberto Capitanio More articles by this author Carlo Andrea Bravi More articles by this author Alexander Mottrie More articles by this author Aalst More articles by this author Belgium More articles by this author Giuseppe Simone More articles by this author Expand All Advertisement PDF downloadLoading ...