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• W3030895408 abstract "e17074 Background: Renal cell carcinoma (RCC) has the highest mortality rate of the genitourinary cancers with detection rising annually for small ( < 4cm) renal masses (SRM). Nephron-sparing partial nephrectomy (PN) is recommended over other approaches such as ablations (Abl). This study aims to evaluate the outcomes and costs associated with treating patients with SRM RCC that undergo PN, laparoscopic cryoablation (lcryo), or various percutaneous ablations-cryoablation (pcryo), microwave (pmv), and radiofrequency (prf). Methods: A retrospective chart review of 295 patients that had either a PN or Abl from 2010-2019 at Beaumont Hospital- Royal Oak was performed. 189 patients with SRM were analyzed. Data collected included demographics, comorbidities, pathology, 30-day ED readmission, recurrence rate, and hospital-billed costs and charges. Data was analyzed using Mann-Whitney, chi-square, unpaired t-tests, Kruskal Wallis post-test, and Dunn’s multiple comparison test. Results: 133 patients with an index Abl (6 lcryo, 73 pcryo, 44 pmv, and 10 prf) and 56 patients with an index PN were analyzed. Mean tumor size for Abl (2.34cm; 90% biopsy-confirmed RCC) and PN (2.48cm; 87% histology confirmed RCC) was comparable. The populations undergoing PN or Abl were similar for both demographics and comorbidities except for age at index procedure (PN 58, Abl 71, p < 0.01). Length of stay (LOS) following index procedure differed with an avg PN LOS = 2.74 days and Abl LOS 0.52 (p < 0.01). 55% of PN patients presented to the ED within 30 days (38% readmitted) whereas only 8% of Abl patients did (42% readmitted)(p < 0.01). The recurrence rate for PN compared to Abl was 23% to 14%, respectively (p = 0.14), with an average follow-up time of 4.95 years for PN and 2.78 years for Abl (p < 0.01). Total hospital charge analysis showed PN being 1.57 the charge of all Abl types (p < 0.01) while cost analysis demonstrated PN being more costly than Abl as a whole by 2.79x (p < 0.01). When evaluating ablation subtypes, trends were noted lcryo being comparable to PN in both charge and cost while percutaneous interventions pmv, pcryo, and prf displayed lower charge and cost when compared to both PN and lcryo. Conclusions: With treatment decisions for SRM RCC are multifactorial, this single-site study demonstrated similar populations with comparable pathologies undergo both PN and Abl procedures. Complication and readmission rates differ between PN and Abl and consideration should be made for these variables as well as the costs associated with each procedure type when managing SRM RCC." @default.
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• W3030895408 date "2020-05-20" @default.
• W3030895408 modified "2023-09-23" @default.
• W3030895408 title "Single-institution analysis of ablations versus partial nephrectomies for small renal masses." @default.
• W3030895408 doi "https://doi.org/10.1200/jco.2020.38.15_suppl.e17074" @default.
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