PD33-02 ASSOCIATION OF DELAYED INTERVENTION AFTER ACTIVE SURVEILLANCE VS IMMEDIATE INTERVENTION OF SMALL RENAL MASSES WITH NEPHRON-SPARING INTERVENTIONS

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy II (PD33)1 May 2024PD33-02 ASSOCIATION OF DELAYED INTERVENTION AFTER ACTIVE SURVEILLANCE VS IMMEDIATE INTERVENTION OF SMALL RENAL MASSES WITH NEPHRON-SPARING INTERVENTIONS Michael Wang, Aaron Wilkie, Andrew McElroy, Jack R. Vercnocke, Monica Van Til, Alice Semerjian, Mahin Mirza, Thomas Maatman, Michael Kozminski, Craig Rogers, Brian Lane, Kevin Ginsburg, and For the Michigan Urological Surgery Improvement Collaborative Michael WangMichael Wang , Aaron WilkieAaron Wilkie , Andrew McElroyAndrew McElroy , Jack R. VercnockeJack R. Vercnocke , Monica Van TilMonica Van Til , Alice SemerjianAlice Semerjian , Mahin MirzaMahin Mirza , Thomas MaatmanThomas Maatman , Michael KozminskiMichael Kozminski , Craig RogersCraig Rogers , Brian LaneBrian Lane , Kevin GinsburgKevin Ginsburg , and For the Michigan Urological Surgery Improvement Collaborative View All Author Informationhttps://doi.org/10.1097/01.JU.0001008912.25331.d7.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: While active surveillance (AS) has become an integral aspect of management for patients with T1RM, tumor growth can occur over time, and is a common indication for delayed intervention (DI). It remains unknown whether patients undergo nephron-sparing intervention (NSI) at similar rates after a period of AS compared to immediate intervention (II). We hypothesized the proportion of NSI is similar in both the II and DI cohorts. METHODS: This is a retrospective review of the Michigan Urological Surgery Improvement Collaborative (MUSIC) KIDNEY prospectively maintained registry. We included all patients with newly diagnosed renal masses ≤7 cm from 05/2017 to 09/2023 who underwent either radical nephrectomy (RN) or NSI. NSI included partial nephrectomy, ablation, or stereotactic body radiation therapy. We compared the proportion of patients who received NSI vs RN among those undergoing II vs DI (>90 days). We fit a mixed-effects multivariable logistic regression model to assess for the adjusted association of II vs DI with the receipt of NSI. RESULTS: We identified 2135 patients, of whom 94% underwent II and 6% underwent a period of AS prior to definitive intervention. Median time from initial clinical encounter to intervention was 43 (IQR 28-62) and 410 (IQR 245-1744) days in the II and DI groups, respectively. We did not appreciate a significant association between DI with receipt of NSI (OR 1.21, 95% CI: 0.71-2.06, p=0.5). The adjusted proportion of NSI from the multivariable model was 75% for patients in both the II and DI cohorts (Figure 1). Instead, fewer comorbidities, lower BMI and RENL score, complex cysts vs. solid mass, and cT1a were associated with the receipt of NSI over RN (Table 1). CONCLUSIONS: Patients undergoing delayed intervention after AS had a similar rate of NSI compared to those undergoing immediate intervention. Active surveillance for SRM does not compromise the ability to perform nephron sparing interventions. Download PPT Source of Funding: Funding from Blue Cross Blue Shield of Michigan © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e709 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Michael Wang More articles by this author Aaron Wilkie More articles by this author Andrew McElroy More articles by this author Jack R. Vercnocke More articles by this author Monica Van Til More articles by this author Alice Semerjian More articles by this author Mahin Mirza More articles by this author Thomas Maatman More articles by this author Michael Kozminski More articles by this author Craig Rogers More articles by this author Brian Lane More articles by this author Kevin Ginsburg More articles by this author For the Michigan Urological Surgery Improvement Collaborative More articles by this author Expand All Advertisement PDF downloadLoading ...