MP49-02 CLEAR CELL LIKELIHOOD SCORES (CCLS) ON MULTIPARAMETRIC MRI DECREASES BENIGN PATHOLOGY RATES IN PATIENTS WITH CHRONIC KIDNEY DISEASE (CKD) BEING CONSIDERED FOR EXTIRPATIVE NEPHRON SPARING SURGERY (NSS)

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You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV (MP49)1 Sep 2021MP49-02 CLEAR CELL LIKELIHOOD SCORES (CCLS) ON MULTIPARAMETRIC MRI DECREASES BENIGN PATHOLOGY RATES IN PATIENTS WITH CHRONIC KIDNEY DISEASE (CKD) BEING CONSIDERED FOR EXTIRPATIVE NEPHRON SPARING SURGERY (NSS) Tara Morgan, Jessica Dai, Vineeth Kommidi, Sam Kusin, Ivan Pedrosa, and Jeffrey Cadeddu Tara MorganTara Morgan More articles by this author , Jessica DaiJessica Dai More articles by this author , Vineeth KommidiVineeth Kommidi More articles by this author , Sam KusinSam Kusin More articles by this author , Ivan PedrosaIvan Pedrosa More articles by this author , and Jeffrey CadedduJeffrey Cadeddu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002075.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: NSS is favored for patients with solid renal masses (SRM) and concurrent CKD. Complication rates are higher than average and operating for benign disease is less permissible. We describe complications and benign pathology rates in a cohort of CKD patients undergoing robotic-assisted partial nephrectomy (RAPN) with utilization of MRI and clear cell likelihood scoring (ccLS). METHODS: A retrospective chart review was performed on 70 patients with CKD (eGFR 15-60) and a pre-operative MRI who underwent RAPN between 4/2016 and 2/2020. CcLS scores from 1 to 5 (1-very unlikely, 2-unlikely, 3-equivocal, 4-likely, and 5-very likely) were assigned prospectively pre-operatively in 54 (77.1%), and post-operatively in the remainder by a blinded radiologist. Clinical characteristics were analyzed using SPSS. Wilcoxon signed rank test compared change in post-operative GFR from baseline (IBM, Armonk, NY). RESULTS: Patient demographics and pre-operative tumor characteristics are in Table 1. The median OR time, blood loss, warm ischemia time and length of stay were 180.5 minutes (IQR 156.0-204.0), 200.0 cc (IQR 100.0-300.0), 23.0 minutes (IQR 18.0-26.0), and 2.0 days (IQR 1.0-3.0), respectively. ccLS scores were 1-5 in 13 (18.6%), 5 (7.1%), 17 (24.3%), 14 (20.0%), and 21 (30.0%), respectively. All patients had a negative margin, and only 4 patients (5.7%) had benign final pathology, outlined in Table 2. One or more complications occurred in 8 patients (11.4%). The median post-operative eGFR (45.0, IQR 33.0-56.0) obtained at a median of 24.9 months (IQR 5.5-51.3) was not significantly lower than baseline (49.0, IQR 36.0-53.0, p=0.67). CONCLUSIONS: RAPN in CKD patients requires careful consideration given increased risk of complications and progression to ESRD. MRI with ccLS scoring may decrease the rate of benign or indolent pathology and even obviate the need for renal biopsy or radical nephrectomy in select cases. Further prospective studies are required. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e874-e875 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tara Morgan More articles by this author Jessica Dai More articles by this author Vineeth Kommidi More articles by this author Sam Kusin More articles by this author Ivan Pedrosa More articles by this author Jeffrey Cadeddu More articles by this author Expand All Advertisement Loading ...