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• W2089831570 abstract "You have accessJournal of UrologyKidney Cancer: Localized (III)1 Apr 20131453 SURVIVAL OUTCOMES AFTER EXTIRPATIVE SURGERY FOR CLINICALLY LOCALIZED RENAL TUMORS ≥7 CM CATEGORIZED BY RENAL SCORE: A MULTICENTER ANALYSIS Ryan Kopp, Reza Mehrazin, Kerrin Palazzi, Michael Liss, Hossein Mirheydar, Ramzi Jabaji, Anthony Patterson, and Ithaar Derweesh Ryan KoppRyan Kopp San Diego, CA More articles by this author , Reza MehrazinReza Mehrazin Philadelphia, PA More articles by this author , Kerrin PalazziKerrin Palazzi San Diego, CA More articles by this author , Michael LissMichael Liss San Diego, CA More articles by this author , Hossein MirheydarHossein Mirheydar San Diego, CA More articles by this author , Ramzi JabajiRamzi Jabaji San Diego, CA More articles by this author , Anthony PattersonAnthony Patterson Memphis, TN More articles by this author , and Ithaar DerweeshIthaar Derweesh San Diego, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2807AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Utilization of partial nephrectomy (PN) for clinical T2 renal masses (T2RM) is increasing; analyses comparing PN to radical nephrectomy (RN) may not account for inherent variability among renal masses ≥7cm. We evaluated survival outcomes of PN compared to RN for T2RM controlling for RENAL score. METHODS Multicenter review of 202 patients (80 PN/122 RN), median follow-up 41.5 months, who underwent RN or PN for T2RM from 1999 to 2012. We excluded metastatic disease or thrombus at presentation. Progressive disease (PD) was defined as new metastases or local recurrence. Patient characteristics, RENAL score, and oncologic outcomes were analyzed within subgroups of RN and PN. Kaplan–Meier analysis compared PD and overall survival (OS) among the entire cohort and within categories of RENAL sum ≥10 and <10 using log rank test. Association between procedure and PD and survival was analyzed using Cox-proportional Hazard models adjusted for clinicopathological characteristics and RENAL score. RESULTS Demographics and comorbidities were similar between PN and RN. Mean tumor size (cm) was larger (p<0.001) in RN (10.2) vs. PN (8.8). PN was more likely to undergo open surgery (p<0.001), and have longer operative time (p=0.011). 4 RN and 10 PN were benign (p=0.02) and excluded from oncologic analysis. No significant differences between PN and RN existed in pathologic T stage, or for RENAL sum and component scores. PD occurred in 28 RN (23.7%) and 9 PN (13.8%), p=0.127, with median time to PD of 18.9 and 21.7 months, respectively. Cox regression demonstrated no association between RN vs. PN and PD, however RENAL sum ≥10 was associated with increased risk of PD (HR 6.69, p=0.002) compared to sum <10. On Kaplan-Meier analysis RN vs. PN had no difference in survival from PD for the entire cohort or within RENAL sum categories ≥10 and <10; Survival from PD was superior for RENAL sum <10 compared to ≥10 (p<0.001) and also for cT2a compared to cT2b tumors (p=0.012). OS was no different between cT2a and cT2b tumors, however RENAL sum ≥10 was more likely to die of disease (p<0.001) or any cause (p<0.001) compared to sum <10. CONCLUSIONS RENAL sum ≥10 is negatively associated with OS among tumors ≥7cm compared to sum <10 and provides additional risk assessment beyond clinical T stage. PN may be oncologically effective for T2RM. Further follow up and prospective randomized investigation is requisite to confirm efficacy of PN for T2RM. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e596 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ryan Kopp San Diego, CA More articles by this author Reza Mehrazin Philadelphia, PA More articles by this author Kerrin Palazzi San Diego, CA More articles by this author Michael Liss San Diego, CA More articles by this author Hossein Mirheydar San Diego, CA More articles by this author Ramzi Jabaji San Diego, CA More articles by this author Anthony Patterson Memphis, TN More articles by this author Ithaar Derweesh San Diego, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2089831570 title "1453 SURVIVAL OUTCOMES AFTER EXTIRPATIVE SURGERY FOR CLINICALLY LOCALIZED RENAL TUMORS ≥7 CM CATEGORIZED BY RENAL SCORE: A MULTICENTER ANALYSIS" @default.
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