MP67-06 LONG-TERM FUNCTIONAL AND ONCOLOGICAL OUTCOMES FOLLOWING PARTIAL NEPHRECTOMY IN SOLITARY KIDNEY PATIENTS
The Journal of Urology（2024）
Abstract
You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy V (MP67)1 May 2024MP67-06 LONG-TERM FUNCTIONAL AND ONCOLOGICAL OUTCOMES FOLLOWING PARTIAL NEPHRECTOMY IN SOLITARY KIDNEY PATIENTS Nicolas A. Soputro, Roxana Ramos-Carpinteyro, Adriana M. Pedraza, Jaya S. Chavali, Carter Mikesell, Robert Abouassaly, Christopher J. Weight, Steven C. Campbell, Robert Stein, Mohamed Eltemamy, Georges P. Haber, and Jihad Kaouk Nicolas A. SoputroNicolas A. Soputro , Roxana Ramos-CarpinteyroRoxana Ramos-Carpinteyro , Adriana M. PedrazaAdriana M. Pedraza , Jaya S. ChavaliJaya S. Chavali , Carter MikesellCarter Mikesell , Robert AbouassalyRobert Abouassaly , Christopher J. WeightChristopher J. Weight , Steven C. CampbellSteven C. Campbell , Robert SteinRobert Stein , Mohamed EltemamyMohamed Eltemamy , Georges P. HaberGeorges P. Haber , and Jihad KaoukJihad Kaouk View All Author Informationhttps://doi.org/10.1097/01.JU.0001009496.54470.10.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Nephron-sparing surgery has been the preferred treatment for suspicious renal mass (SRM) in solitary kidney patients, with a strong emphasis on optimal oncological outcome and preservation of renal function. This study sought to evaluate the long-term oncological and functional outcomes in patients with solitary kidneys who underwent partial nephrectomy (PN) in our single institution. METHODS: A retrospective review was performed on the prospectively maintained, IRB-approved database to identify all patients who underwent PN for the management of SRM between 2010 and 2021. Perioperative and postoperative variables were collected and statistical analysis was performed using R Project for Statistical Computing. RESULTS: A total of 193 patients with solitary kidneys were included with a median age of 65 years and a median BMI of 30.4 kg/m2. The median RENAL nephrometry score was 9, which included 72.6% intermediate-high complexity tumors. Intraoperative complication occurred in 9.3% with two cases being converted to radical nephrectomy due to tumor invasion as well as extensive adhesion and bleeding. The median ischemia time was 26 minutes. Positive surgical margin was observed in 15.5% and major postoperative complication was identified in 17.6%. Despite 77% experiencing acute kidney injury in the early postoperative period, subsequent renal function improvements within 12 months were noted in 85% of the group. With a follow-up time of up to 162 months, the incidence of clinically significant CKD upstaging beyond 12 months was 30%. No significant predictors of long-term renal function were found in univariate analysis. Tumor recurrence was identified in 31 patients. CONCLUSIONS: PN remains a feasible alternative for the management of SRM in patients with solitary kidneys. The incidence of acute kidney injury at the time of discharge was often followed by the recovery of renal function to a new baseline. No perioperative variables were identified as potential predictors of long-term renal function beyond 12 months. Download PPTDownload PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1098 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Nicolas A. Soputro More articles by this author Roxana Ramos-Carpinteyro More articles by this author Adriana M. Pedraza More articles by this author Jaya S. Chavali More articles by this author Carter Mikesell More articles by this author Robert Abouassaly More articles by this author Christopher J. Weight More articles by this author Steven C. Campbell More articles by this author Robert Stein More articles by this author Mohamed Eltemamy More articles by this author Georges P. Haber More articles by this author Jihad Kaouk More articles by this author Expand All Advertisement PDF downloadLoading ...
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