Data was gathered at two centers from 2008-2015 on patients managed with nephron-sparing surgery. Their primary outcomes were preservation of the ipsilateral parenchymal mass and global GFR. Parenchymal mass was estimated by comparing the vascularized parenchymal region on pre- and post-operative CT imaging. Global GFR was measured by pre- and post-operative serum creatinine.
They found no differences in tumor characteristics (i.e. tumor size, R.E.N.A.L. score) or pre-operative GFR between the TE (n=7) and PN (n=373). Capsular closure was more often performed in PN and the parenchymal mass was preserved more often in TE than PN (95% vs. 84%, p < 0.05). The global GFR preservation was higher in the TE vs. PN group, but they found a higher positive margin rate for TE vs. PN (8.5% vs. 4.8%, p < 0.05).
Dr. Suk-Ouichai concludes that TE can improve parenchymal mass preservation and renal function preservation, however the higher positive margin rate is concerning, and its clinical significance needs further evaluation.
Presented by: Chalairat Suk-Ouichai, MD
Written by: Egor Parkhomenko, Department of Urology, University of California-Irvine at the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA