MP54-08 PARTIAL VERSUS RADICAL NEPHRECTOMY FOR T1 RENAL TUMOURS: AN ANALYSIS FROM THE BRITISH ASSOCIATION OF UROLOGICAL SURGEONS (BAUS) NEPHRECTOMY AUDIT

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You have accessJournal of UrologyKidney Cancer: Localized III1 Apr 2014MP54-08 PARTIAL VERSUS RADICAL NEPHRECTOMY FOR T1 RENAL TUMOURS: AN ANALYSIS FROM THE BRITISH ASSOCIATION OF UROLOGICAL SURGEONS (BAUS) NEPHRECTOMY AUDIT Marios Hadjipavlou, Fahd Khan, Sarah Fowler, Francis Xavier Keeley, and Seshadri Sriprasad Marios HadjipavlouMarios Hadjipavlou More articles by this author , Fahd KhanFahd Khan More articles by this author , Sarah FowlerSarah Fowler More articles by this author , Francis Xavier KeeleyFrancis Xavier Keeley More articles by this author , and Seshadri SriprasadSeshadri Sriprasad More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1597AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives The increasing incidence of small renal tumours has changed practice towards nephron-sparing and minimally invasive techniques (MIT). The objective of this study was to analyse and compare data from The BAUS Nephrectomy Audit for outcomes of partial and radical nephrectomy for T1 renal tumours. Methods UK consultants were invited to submit data prospectively on all patients undergoing nephrectomy between 1st January and 31st December 2012 to a national database using a standard proforma. Analysis was made on patient demographics, operative technique and peri operative data/outcome between partial and radical nephrectomy for T1 tumours. Results Data from 5,851 nephrectomies were reported by 307 consultant urologists. A total of 1,768 nephrectomies were performed for T1 renal tumours. Of these, 1,082 (61.2%) were radical nephrectomies (RN) and 686 (38.8%) were partial nephrectomies (PN). The mean age of patients undergoing PN was lower (PN 59 vs RN 64; p<0.0001) and so was the WHO performance score (PN 0.4 vs RN 0.7; p<0.0001). PN for the treatment of T1a (≤4cm) tumours accounted for 55.6% of which 44% were performed using a MIT. For T1b (4-7cm) tumours, 19% underwent PN, in 33.3% of which a MIT was adopted. Majority of RNs for T1 tumours were performed using a MIT (90.3%). Of the laparoscopic PNs, 30.5% were robot-assisted. No significant difference in intra operative complications was found between the RN and PN groups (4% vs 4.3% respectively; p=0.79). However PN accounted for a higher postoperative complications rate (RN 11.3% vs PN 17.6%; p=0.0002). Operative time between RN and PN was comparable (141min vs 145min; p=0.25). Blood loss was less in the RN group (mean for RN 165mL vs PN 323mL; p<0.0001), however, transfusion rates were similar (3.2% vs 2.6% respectively; p=0.47). RN was associated with a shorter length of stay (median 4 days vs 5 days; p=0.0004). Comparison between robot-assisted and laparoscopic PN showed no significant differences in operation time, blood loss, warm-ischaemia time or complications. Conclusions PN was the modality of choice for treatment of T1a tumours whereas RN was preferred for T1b tumours. MIT have been widely adopted for RN but not for PN. The age and WHO performance status would have influenced decision making. Despite the advances in surgical technique, a substantial risk of postoperative complications remains with PN. © 2014FiguresReferencesRelatedDetails Volume 191 Issue 4S April 2014 Page: e574-e575 Advertisement Copyright & Permissions© 2014Metrics Author Information Marios Hadjipavlou More articles by this author Fahd Khan More articles by this author Sarah Fowler More articles by this author Francis Xavier Keeley More articles by this author Seshadri Sriprasad More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...