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• W4255280471 abstract "You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy V1 Apr 2018MP48-11 FUNCTIONAL PARENCHYMAL VOLUME-BASED SPECTRUM SCORE IS ABLE TO QUANTIFY ISCHEMIC INJURY AFTER PARTIAL NEPHRECTOMY Ziho Lee, Robert Uzzo, Aeen Asghar, Phyllis Parkansky, Tianyu Li, Rosalia Viterbo, David Chen, Marc Smaldone, and Alexander Kutikov Ziho LeeZiho Lee More articles by this author , Robert UzzoRobert Uzzo More articles by this author , Aeen AsgharAeen Asghar More articles by this author , Phyllis ParkanskyPhyllis Parkansky More articles by this author , Tianyu LiTianyu Li More articles by this author , Rosalia ViterboRosalia Viterbo More articles by this author , David ChenDavid Chen More articles by this author , Marc SmaldoneMarc Smaldone More articles by this author , and Alexander KutikovAlexander Kutikov More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1510AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The Spectrum Score (SS) has been proposed as a means to unmask acute ipsilateral renal dysfunction after partial nephrectomy (pNx). However, this novel metric has yet to be validated in an external cohort. Also, as initially defined, SS calculations require renal split function assessment via renal scans, which are uncommonly available in routine practice. We externally validate the utility of SS using a modified SS calculation that uses functional parenchymal volume (FPV) and does not require renal scans. METHODS We retrospectively reviewed our institutional renal mass database to identify patients with a solitary renal mass and a functional contralateral kidney who underwent pNx between 1/2015 and 1/2016. FPV was calculated by cylindrical volume approximation, and was used to quantitate relative preoperative and postoperative renal function. SS was calculated as previously reported by considering two extreme scenarios: ideal peak creatinine (Cr), the expected Cr assuming no ischemic injury; and worst case peak Cr, the expected Cr assuming temporary complete non-function of the ipsilateral kidney. Acute ipsilateral renal dysfunction was quantified as the FPV-based SS: (observed peak Cr-ideal peak Cr) / (worst case peak Cr-ideal peak Cr). Recovery from ischemia in the operated kidney was quantified by functional recovery (FR): (% function saved) / (% parenchyma preserved). Linear regression analyses were used to assess factors associated with SS and FR. RESULTS Of 101 eligible patients, median age at surgery was 59 years (IQR 49-66), tumor diameter was 3 centimeters (IQR 2.5-4.3), and Nephrometry Score sum was 7.5 (IQR 6-9). Twelve/101 (12%) cases were performed off clamp, while 89/101 (88%) cases were performed with a median warm ischemia time of 23 minutes (IQR 17-33). Median FPV preservation was 94.5% (IQR 80.7-100). On multivariable analysis, older age at surgery (p=0.046) was associated with an increased FPV-based SS, but body mass index, Charlson Comorbidity Index, tumor size, Nephrometry Score sum, preoperative renal function, warm ischemia time, estimated blood loss, and operative time were not (all p >0.05). Also, on multivariable analysis, decreased preoperative renal function (p=0.010), warm ischemia time (p=0.013), and FPV-based SS (p<0.001) were associated with an increased FR, but the other aforementioned covariates were not (all p>0.05). CONCLUSIONS The novel FPV-based SS, which avoids reliance on renal scans, is a high fidelity metric that quantifies acute ipsilateral renal dysfunction after pNx and is a strong predictor of FR. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e629 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Ziho Lee More articles by this author Robert Uzzo More articles by this author Aeen Asghar More articles by this author Phyllis Parkansky More articles by this author Tianyu Li More articles by this author Rosalia Viterbo More articles by this author David Chen More articles by this author Marc Smaldone More articles by this author Alexander Kutikov More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W4255280471 title "MP48-11 FUNCTIONAL PARENCHYMAL VOLUME-BASED SPECTRUM SCORE IS ABLE TO QUANTIFY ISCHEMIC INJURY AFTER PARTIAL NEPHRECTOMY" @default.
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