Login to Access Video or Poster Abstract: MP59-08
Sources of Funding: None

Introduction

The renal tumour Contact Surface Area has been recently proposed to predict perioperative outcomes in patients who underwent partial nephrectomy. However, until now no study performed an external validation of this system. The aim of this study was to test the role of CSA to predict intraoperative and postoperative parameters in a series of consecutive patients who underwent PN.

Methods

We prospectively evaluated the clinical and pathological records of 81 consecutive patients who underwent open PN at our Institution between July 2013 and July 2016. All the clinical and pathological records are collected in a dedicated database. The CSA was calculated using the preoperative abdominal CT scan images and applying the formula recently described by Leslie et al [Eur. Urol. 2014; 66: 884]. Then, this continuous variable was categorized in two groups according to the predefined 20 cm2 cut-off value. The following outcomes were considered: clamping of the renal artery, early unclamping technique, warm ischemia time (WIT), estimated blood loss (EBL), overall postoperative complications. ROC curve analyses were used to compare PADUA score and CSA.

Results

The median value of CSA was 13.6 (IQR 8-23.6) cm2. In 23 (28.3%) cases a no clamp technique was performed. In the remaining 58 (71.6%) cases the median warm ischemia time was 13 min. An early unclamping technique was performed in 41/81 (50.6%). The median EBL was 300 ml. Overall postoperative complications were detected in 27/81 (33.3%) cases. However, major complications (grade 3-4) were reported only in 6 (7.4%) cases. The CSA predicted the clamping of the main artery (p=0.001), the use of an early unclamping technique (p=0.005), the WIT (p<0.0001), the EBL (p<0.001), the overall postoperative complications (p=0.002). PADUA score and CSA resulted overlapping to predict clamp versus no clamp technique (AUC 0.84 Vs 0.84) and overall complications (AUC 0.68 Vs 0.68). Conversely, CSA resulted better than PADUA score to predict WIT > 20 min (AUC 0.77 Vs 0.63).

Conclusions

The renal tumour CSA seems to be a valid predictor of postoperative PN outcomes. Its role must be confirmed in larger series. Moreover, CSA seems to give information similar to PADUA score. Contact surface area seems to be a valid predictor of postoperative outcomes after partial nephrectomy.

Funding

None