MP37-07\u2003WHO WILL BENEFIT MOST FROM PARTIAL NEPHRECTOMY IN T1B TUMORS?: PREDICTIVE FACTORS FOR FUNCTIONAL OUTCOME AFTER RADICAL NEPHRECTOMY

Abstract

INTRODUCTION AND OBJECTIVES: Partial nephrectomy is progressively being utilized for larger tumors, however it is frequently challenging. In this study we aimed to explore which patients with T1b tumors will benefit most from partial nephrectomy by studying the predictive factors for functional outcome after radical nephrectomy. METHODS: Patients with localized T1b renal cancer who had been treated by radical nephrectomy from Nov. 2005 to Jan. 2016 were reviewed. Functional recovery of >90% from preoperative eGFR during 3-years post-nephrectomy was studied. Those with multiple tumors, ESRD, history of transplantation, and urologic malformation such as horseshoe kidney were excluded from the study. RESULTS: During the study period 211 patients were included in the study. 41 patients were included in the recovery group (>90% recovery) and 170 patients were included in the non-recovery group (⩽90% recovery). Patients in the recovery group were more likely to be female (53.7% vs 30.0%, p=0.004), ASA class1 (58.5% vs 41.8%, p=0.048), and CKD grade3 (12.2% vs 3.5%). On multivariable logistic regression analysis and cox regression analysis these three factors remained as significant factors predicting >90% recovery of renal function. (Table 1A, Figure 1) The same factors were also significant predictors of percentile functional recovery on multivariable linear regression analysis. (Table 1B). CONCLUSIONS: Among patients presenting with T1b renal tumors those who are male, ASA class 2 or higher, and CKD grade2 or lower are less likely to recover renal function after radical nephrectomy. These patients are more likely to benefit from nephron sparing surgery. Figure. No caption available. Table. No title available. Source of Funding: none