AUA 2018: On-Clamp vs Off-Clamp Partial Nephrectomy: Propensity Score Matched Comparison of Long Term Functional Outcomes
San Francisco, CA (UroToday.com) The purpose of this study was to compare renal functional outcomes after either off-clamp (Off-C) or on-clamp (On-C) partial nephrectomy (PN) in patients with cT1-2/N0 M0 renal tumors and baseline estimated eGFR >60 ml/min. This study used a prospective “renal cancer” database of two high volume centers. The database was queried for “cT1-2/N0/M0” tumors and “baseline eGFR>60 mL/min”.
AUA 2018: Variability in Partial Nephrectomy Outcomes: Does Your Surgeon Matter?
San Francisco, CA USA (UroToday.com) Recently, there have been many publications citing the difference amongst surgeon skill and technique in partial nephrectomy. Julien Dagenais, MD emphasized these articles in the beginning of his talk by mentioning fifteen articles surrounding this topic. Understanding discrepancies between surgeons is increasingly important in the pursuit of quality-based healthcare in the United States.
AUA 2018: Does Partial Nephrectomy for Biopsy Proven Fuhrman Grade 3/4 Renal Cell Carcinoma Confer Worse Outcomes Compared to Radical Nephrectomy?
San Francisco, CA (UroToday.com) To date, no evidence exists on whether the treatment with radical nephrectomy (RN) for non-metastatic grade 3/4 renal cell carcinoma (RCC) tumors confers better overall outcomes than treatment with partial nephrectomy (PN). In this study the authors aimed to analyze and compare results of patients with biopsy proven grade 3 / 4 RCC treated with either PN or RN.
AUA 2018: Oncologic Outcomes of Simple Enucleation Partial Nephrectomy in Sporadic Type 2 Papillary Renal Cell Carcinoma
San Francisco, CA (UroToday.com) Papillary type 2 renal cell carcinoma (RCC) has been associated with poor prognosis and increased risk of local recurrence according to studies in patients with Hereditary Leiomyomatosis and RCC. The current recommendation for patients found to have papillary type 2 features on biopsy is for radical nephrectomy or partial nephrectomy with a wide margin. The authors aimed to assess the margin rate along with fossa recurrence rate of patients with sporadic type 2 papillary RCC who underwent simple enucleation partial nephrectomy as compared to those with clear cell RCC.
AUA 2018: Frozen Sections for Margins During Partial Nephrectomy Do Not Influence Recurrence Rates
San Francisco, CA USA (UroToday.com) Julien Dagenais, MD and colleagues made the argument that frozen sections for margins during partial nephrectomy do not influence recurrence rates. Even the era of robotic partial nephrectomy with the magnification and high definition vision, urologists are still anecdotally are still performing frozen sections at the tumor base. The reason to perform a frozen section is to confirm negative margin status for clinically localized renal cell carcinoma. However, their oncologic benefit remains unclear and there have been no studies investigating the long-term impact of frozen section on local or metastatic recurrence. The objective of this study was to determine whether the utilization of a frozen section for this purpose during partial nephrectomy influenced recurrence rates.
AUA 2018: Surgical Techniques: Tips & Tricks: Dissection of the Renal Mass with Hilar Fat Invasion
San Francisco, CA USA (UroToday.com) Dr. Monish Aron discussed tips and tricks for resecting renal masses with Hilar fat invasion. Dr. Aron states that being prepared for these tumors is important, considering that they may be difficult to predict on preoperative imaging. Not recognizing these tumors may lead to tumor violation or positive surgical margins, leading to potential implications for prognosis. The incidence of upstaging a tumor to pT3a is certainly not uncommon.
AUA 2018: Tips and Tricks – Open Partial Nephrectomy
San Francisco, CA (UroToday.com) Van Poppel, MD, from Belgium presented the European Urological Association (EAU) lecture, discussing his personal experience with open partial nephrectomy. Van Poppel started by highlighting that the EAU guidelines state that (i) patients with T1 renal masses should undergo nephron-sparing surgery rather than radical nephrectomy whenever possible, and (ii) for solitary renal tumors up to a diameter of 7cm, nephron-sparing surgery is the standard procedure, whenever technically feasible.