Abstract: PD20-05
Sources of Funding: none

Introduction

The role of partial nephrectomy (PN) for T2 renal tumors is less established. We reviewed the National Cancer Database (NCDB) to compare the complications and overall survivals of PN and RN for T2N0M0 tumors.

Methods

We reviewed the NCDB from 2004 to 2014 to identify all T2N0M0 renal cancers treated with partial or radical nephrectomies. Variables of interest included patient demographics, tumor characteristics, margin status, conversion from minimally invasive (MIS) to open approach, length of stay, 30-day unplanned readmissions and overall survival. The hazard ratios (HR) of variables on survivals were determined by Cox regression analysis. Survival curves were plotted. p-value <0.05 defined statistical significance in all analyses.

Results

A total of 22586 patients had T2N0M0 renal cancer treated with PN or RN._x000D_ _x000D_ Table 1 shows patient demographics and tumor characteristics between the groups._x000D_ _x000D_ Table 2 shows margins status, conversion from MIS to open approach, length of stay and 30-day unplanned readmissions between the groups._x000D_ _x000D_ Mean duration of follow-up was 44.4 months and 48.4 months for PN and RN respectively. Diagram 1 shows overall survival curves in the 2 groups (p < 0.0005 by Log rank, Breslow & Tarone-Ware tests)._x000D_ _x000D_ Table 3 shows HR of variables on overall survival by Cox regression analysis. Age, Charlson score, tumor size, histology and grade exert significant effects on survival. A clear survival trend is also seen with socioeconomic status based on income and education, but may not achieve statistical significance.

Conclusions

While associated with a slightly higher positive margin rate and longer mean duration of stay, PN results in better overall survival than RN for T2N0M0 renal tumors.

Funding

none