stage (Figure 1). Patients who underwent PN had ... Srinivas Vourganti, Syracuse, NY; Alexander Kutikov, Philadelphia, PA;. Gennady Bratslavsky, Syracuse, NY.
THE JOURNAL OF UROLOGYâ
Vol. 197, No. 4S, Supplement, Friday, May 12, 2017
e263
Source of Funding: none
MP22-16
Source of Funding: H&H Lee Surgical Resident Research Scholarship
CYTOREDUCTIVE PARTIAL NEPHRECTOMY FOR SMALL PRIMARY TUMORS IMPROVES OVERALL SURVIVAL IN METASTATIC KIDNEY CANCER Andrew Lenis*, Amir Salmasi, Izak Faiena, Nicholas Donin, Alexandra Drakaki, Arie Belldegrun, Allan Pantuck, Karim Chamie, Los Angeles, CA INTRODUCTION AND OBJECTIVES: Cytoreductive radical nephrectomy (RN) improves survival in select patients with metastatic renal cell carcinoma (mRCC). For smaller primary tumors, however, it is unknown whether cytoreductive partial nephrectomy (PN) compromises oncologic efficacy. Our objective was first to evaluate whether the size of the primary tumor is associated with overall survival (OS) in mRCC. Second, we sought to evaluate whether PN had equivalent OS compared with RN in patients with small primary tumors. METHODS: We queried the National Cancer Database from 2004-2013 and identified patients who underwent cytoreductive PN or RN for mRCC. Tumor size was categorized as T1a, T1b, and T2a. Rates of cytoreductive PN were analyzed over time. Descriptive statistics were used to compare patient demographics and tumor characteristics by surgical procedure (PN vs. RN) and tumor size. KaplanMeier survival analysis was used to compare OS. Multivariable Cox proportional hazards models were used to determine the effect of surgery type on OS. RESULTS: A total of 4,464 patients met our inclusion criteria, with 94.4% undergoing a RN and 5.6% undergoing a PN. Rates of cytoreductive PN increased over time from 3.2% in 2004 to 9.4% in 2013. One-year OS was 71.3%, 69.2%, and 61.7% in patients with T1a, T1b, and T2a primary tumors, respectively (log rank test: p
