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MP41-20 RACE EFFECTS ON PATHOLOGICAL AND FUNCTIONAL OUTCOMES AFTER ROBOTIC PARTIAL NEPHRECTOMY
THE JOURNAL OF UROLOGYâ
e568
Vol. 195, No. 4S, Supplement, Sunday, May 8, 2016
RESULTS: The median age at the time of surgery was 62 years (inter-quartile range 53-70), 67% were men. The average tumor size (standard deviation) was 3.3cm (1.4), in a range of 1-8cm. Local recurrence was found in 20 patients (2.8%) at an average of 31.5 (26.6) months after surgery. Among these, renal local recurrence was found in 18 (90%) patients, peri-renal in 5 (25%), and in 3 patients (15%) a combined recurrence. 16 (80%) and 3 (15%) of the patients with local recurrence were treated with radical and partial nephrectomy respectively. The last patient was treated medically only. Moreover, among these 20 patients, in 6 patients a metastatic progression was found. In 3 patients at the time of local recurrence and in 3 patients after 24-45 months after the local recurrence. Local recurrence was not significantly related to positive surgical margins (p¼0.10), histological type (p¼0.26), Age (p¼0.88), and gender (p¼0.41), but was significantly related to the tumor stage (p¼0.001) and grade (p<0.001). Metastatic progression and tumor related death rates were significantly higher in the group of patients with local recurrence (p<0.001, p<0.001, respectively). CONCLUSIONS: The incidence of local recurrence after partial nephrectomy for primary renal tumors is very low and was associated with tumor stage and grade. All the patients beside one, were treated surgically for the local recurrence. Local recurrence is associated with increased rates of metastatic progression and death of disease. Source of Funding: none
MP41-20 RACE EFFECTS ON PATHOLOGICAL AND FUNCTIONAL OUTCOMES AFTER ROBOTIC PARTIAL NEPHRECTOMY Onder Kara*, Hiury Andrade, Homayoun Zargar, Oktay Akca, Matthew Maurice, Peter Caputo, Daniel Ramirez, Ercan Malkoc, Charles Modlin, Jihad Kaouk, Cleveland, OH INTRODUCTION AND OBJECTIVES: The incidence of RCC has risen more rapidly in the African-American (AA) population compared to non-AA patients in the United States. Our aim was to explore the potential effects of race on pathological outcomes of renal tumor and on kidney function preservation in the patients undergoing robotic partial nephrectomy (RPN) at our center. METHODS: Retrospective review of our institutional review board approved database for patients undergoing RPN from 2006-2014 was performed. AA and non-AA groups were compared with regards to demographics, tumor characteristics, functional data and, oncological outcomes. For functional outcomes, groups were matched (1:1) in terms of age, preoperative estimated glomerular filtration rate (eGFR) and R.E.N.A.L score. RESULTS: From the total of 1005 patients, 84 were AA. Age and the tumor size were comparable between the two groups (2.7 vs. 3 cm; p¼0.29). Proportion of patients with papillary RCC was higher among AAs compared to non-AAs (43.3% vs. 19.4%; p<0.001) (Table 1). After matching AA patients with non-AA counterparts (1:1 matching), eGFR preservation at latest follow up after surgery was comparable between groups (84.3% vs. 85%; p¼0.25) (Table 2). AA race (OR 3.62, p<0.001), male gender (OR 2.05, p<0.001) and low preoperative eGFR (OR 0.97, p<0.001) were predictors of papillary RCC on multivariate analyses (Table 3). CONCLUSIONS: The incidence of papillary RCC is higher in AA patients undergoing RPN. There was no difference in kidney function recovery after RPN in both AA and non-AA groups. AA race itself is not a significant factor in determining renal malignancy. Further studies are needed to clarify the impact of higher prevalence of papillary tumors in AA group in terms of long-term oncological and functional outcomes.
Source of Funding: none
e568
Vol. 195, No. 4S, Supplement, Sunday, May 8, 2016
RESULTS: The median age at the time of surgery was 62 years (inter-quartile range 53-70), 67% were men. The average tumor size (standard deviation) was 3.3cm (1.4), in a range of 1-8cm. Local recurrence was found in 20 patients (2.8%) at an average of 31.5 (26.6) months after surgery. Among these, renal local recurrence was found in 18 (90%) patients, peri-renal in 5 (25%), and in 3 patients (15%) a combined recurrence. 16 (80%) and 3 (15%) of the patients with local recurrence were treated with radical and partial nephrectomy respectively. The last patient was treated medically only. Moreover, among these 20 patients, in 6 patients a metastatic progression was found. In 3 patients at the time of local recurrence and in 3 patients after 24-45 months after the local recurrence. Local recurrence was not significantly related to positive surgical margins (p¼0.10), histological type (p¼0.26), Age (p¼0.88), and gender (p¼0.41), but was significantly related to the tumor stage (p¼0.001) and grade (p<0.001). Metastatic progression and tumor related death rates were significantly higher in the group of patients with local recurrence (p<0.001, p<0.001, respectively). CONCLUSIONS: The incidence of local recurrence after partial nephrectomy for primary renal tumors is very low and was associated with tumor stage and grade. All the patients beside one, were treated surgically for the local recurrence. Local recurrence is associated with increased rates of metastatic progression and death of disease. Source of Funding: none
MP41-20 RACE EFFECTS ON PATHOLOGICAL AND FUNCTIONAL OUTCOMES AFTER ROBOTIC PARTIAL NEPHRECTOMY Onder Kara*, Hiury Andrade, Homayoun Zargar, Oktay Akca, Matthew Maurice, Peter Caputo, Daniel Ramirez, Ercan Malkoc, Charles Modlin, Jihad Kaouk, Cleveland, OH INTRODUCTION AND OBJECTIVES: The incidence of RCC has risen more rapidly in the African-American (AA) population compared to non-AA patients in the United States. Our aim was to explore the potential effects of race on pathological outcomes of renal tumor and on kidney function preservation in the patients undergoing robotic partial nephrectomy (RPN) at our center. METHODS: Retrospective review of our institutional review board approved database for patients undergoing RPN from 2006-2014 was performed. AA and non-AA groups were compared with regards to demographics, tumor characteristics, functional data and, oncological outcomes. For functional outcomes, groups were matched (1:1) in terms of age, preoperative estimated glomerular filtration rate (eGFR) and R.E.N.A.L score. RESULTS: From the total of 1005 patients, 84 were AA. Age and the tumor size were comparable between the two groups (2.7 vs. 3 cm; p¼0.29). Proportion of patients with papillary RCC was higher among AAs compared to non-AAs (43.3% vs. 19.4%; p<0.001) (Table 1). After matching AA patients with non-AA counterparts (1:1 matching), eGFR preservation at latest follow up after surgery was comparable between groups (84.3% vs. 85%; p¼0.25) (Table 2). AA race (OR 3.62, p<0.001), male gender (OR 2.05, p<0.001) and low preoperative eGFR (OR 0.97, p<0.001) were predictors of papillary RCC on multivariate analyses (Table 3). CONCLUSIONS: The incidence of papillary RCC is higher in AA patients undergoing RPN. There was no difference in kidney function recovery after RPN in both AA and non-AA groups. AA race itself is not a significant factor in determining renal malignancy. Further studies are needed to clarify the impact of higher prevalence of papillary tumors in AA group in terms of long-term oncological and functional outcomes.
Source of Funding: none