Klinger et al (Poster #158) used a cohort of 336 patients
from an international collaboration to study the correlation
of preoperative assessment of volume preservation
(PAVP) and surgeon postoperative assessment of volume
preservation (SAVP) with postoperative renal functional
outcomes in patients undergoing partial nephrectomy.
The authors noted that PAVP and SAVP were moderately
correlated with each other, and that they were correlated
with postoperative GFR.
SURGICAL OUTCOMES
Ingham et al (Poster #153) studied the effect of aspirin
on outcomes of over 10,000 patients undergoing partial
nephrectomy using the Premier Hospital Database. 774
patients were noted to be taking aspirin. Patients on aspirin
undergoing minimally invasive partial nephrectomy
were less likely to need a blood transfusion. Patients on
aspirin were more likely to experience a major cardiovascular
event regardless of surgical approach.
Baiocco et al (Poster #161 and Poster #162) evaluated
the role of multiplex partial nephrectomy MPN (partial
nephrectomy for 3 or more tumors) in solitary kidneys,
and compared outcomes with patients undergoing standard
partial nephrectomy (SPN). The authors noted that
patients who underwent MPN had more blood loss, more
blood transfusions, longer hospital stay, higher rate of
Clavien grade 3 complications, more need for permanent
hemodialysis, and higher local recurrence rates. In addition,
the outcomes were not statistically different in patients
undergoing repeat MPN abd those patients undergoing
initial MPN.
Ryan et al (Poster #169) studied the effect of diabetes
mellitus on outcomes in 3,041 patients with RCC treated
with surgery. The authors noted that diabetes did not impact
recurrence free survival in RCC, but only overall survival.
They also noted that patients with stage I RCC,
those who had radical nephrectomy in the setting of
being diabetic had worse outcomes compared to those
who had partial nephrectomy and those without diabetes,
while diabetes was not associated with overall survival
in patients with stage II-IV.
Ristau et al (Poster #151) studied the safety and effectiveness
of partial nephrectomy in a cohort of patients
with high-complexity tumors (RENAL nephrometry score
10-12) treated at 4 institutions. They did not note a difference
in 30-day complications between partial nephrectomy
and radical nephrectomy. On multivariable
analysis, recurrence-free survival was higher for patients
who underwent partial nephrectomy, while overall survival
was not different, indicating a likely selection bias.
Gomella et al (Poster #155) studied the outcomes of
nephrectomy and lymphadenectomy in 17 patients with
hereditary leiomyomatosis and RCC with clinically positive
nodes. Median number of nodes removed was 24,
108 Kidney Cancer Journal
and median number of positive nodes was 4. Four patients
(24%) were still disease free at time of last followup,
while 9 patients (69%) had tumor recurrence within
the lymphadenectomy template boundaries, pointing toward
the need for more aggressive systemic therapy in
this patient population.
OTHER
Kaushik et al (Poster #142) used an open-source platform
to study kidney cancer care disparities in South
Texas (within the catchment area for University of Texas
Health Science Center in San Antonio). The authors
noted that kidney cancer incidence was significantly
higher in Hispanics compared to Non-Hispanic Whites,
in all ages groups over 20, with a strong male to female
ratio.
Xia et al (Poster #43) used the NCDB to investigate the
correlation between hospital volumes and outcomes of
over 18,000 patients who underwent robotic assisted partial
nephrectomy, and found that higher volume hospitals
experience better outcomes (lower rate of conversion
to open surgery, lower rate of hospital stay>3 days, and
lower rate of positive surgical margins).
Metastatic
Peyton et al (Poster #38) used a cohort of 293 patients
with metastatic RCC with IVC tumor thrombus to study
the prognostic role of neutrophil-lymphocyte ratio (NLR).
Patients with lower NLR experienced longer overall survival.
They noted that NLR could substratify patients with
intermediate risk MSKCC (but not good or poor risk patients)
into 2 clearly different groups (OS of 24 months
versus 12 months for those with low NLR versus high
NLR, respectively).
Martin et al (Poster #146) used a cohort of patients with
metastatic RCC with primary in place, enrolled on a
phase 3 clinical trial of sunitinib versus sunitinib + AGS-
003, to study chronic kidney disease after cytoreductive
nephrectomy in patients with preoperative GFR over 60.
Of the 371 patients, 45.5% developed stage 3 or worse
chronic kidney disease on short-term follow-up. Factors
that predicted this finding included age, hypertension,
Charleson Comorbidity Index, history of renal stones,
and presence of liver metastatic disease.
Xia et al (Poster #41) used the NCDB to evaluate patients
with RCC with oligometastatic disease from 2010-2013
who underwent cytoreductive nephrectomy, in order to
study the value of metastasectomy in this cohort. Of the
2395 patients in this study, 14.7% underwent a metastasectomy.
Patients who underwent a metastasectomy were
noted (while controlling for comorbidity) to have longer
OS (HR=0.65, OS of 37.5 months versus 20.8 months in
no-metastasectomy patients), and to receive targeted therapy
less frequently (44.0% versus 56.1%).