Mp56-04 Initial Renal Mass Histology Informs Contralateral Histology for Patients With Bilateral Renal Masses

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV (MP56)1 May 2024MP56-04 INITIAL RENAL MASS HISTOLOGY INFORMS CONTRALATERAL HISTOLOGY FOR PATIENTS WITH BILATERAL RENAL MASSES Jason M. Scovell, Kieran Lewis, Eran Maina, Carlos Munoz-Lopez, and Steven C. Campbell Jason M. ScovellJason M. Scovell , Kieran LewisKieran Lewis , Eran MainaEran Maina , Carlos Munoz-LopezCarlos Munoz-Lopez , and Steven C. CampbellSteven C. Campbell View All Author Informationhttps://doi.org/10.1097/01.JU.0001008940.44711.d4.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Patients with bilateral renal masses provide a unique challenge which, at most centers, necessitates two separate operations to minimize the risk of acute renal failure. The relevance of initial pathology on subsequent surgical decisions remains unknown. We sought to identify the frequency at which the second surgical site shared or diverged with respect to malignancy potential from the first renal mass excision. METHODS: A retrospective review was performed for all patients at a single center (2002-2022) who underwent staged renal intervention (partial, ablation, or radical nephrectomy) for bilateral renal masses who had available bilateral pathology. Tumors were categorized by their malignant potential - malignant (clear cell, papillary, chromophobe, acquired cystic disease RCC, unclassified RCC, spindle cell, cystic disease associated RCC), indolent (oncocytic neoplasm of low malignant potential, multilocular cystic RCC), and benign (oncocytoma, angiomyolipoma, papillary adenoma, and clear cell papillary histology). For synchronous tumors, the index tumor was defined as the largest tumor on cross-sectional imaging. RESULTS: A total of 382 patients underwent bilateral renal mass intervention between 2002 - 2022. Median age was 61 years, and median time between surgical procedures was 3.8 months. 83% of tumors were classified as cancer, 6% as indolent, and 12% as benign (Table 1a). Tumors were synchronous in 79% of cases. When the initial tumor was cancer, the contralateral tumor was malignant in 92% of cases. When the initial tumor was benign, the second tumor was benign in 71% of cases. Only 38% of tumors resected after indolent tumor removal were cancerous representing an overall shift towards favorable histology. For synchronous tumors, the index tumor was operated on first in 59% for partial then partial, 39% for radical then partial, 70% for radical then ablation, and 67% for partial then ablation (Table 1b). CONCLUSIONS: For patients who have already undergone initial partial or radical nephrectomy, concordance rates are excellent. This information could aid in both patient counseling and surgical decision making for patients with bilateral RCC managed in a staged manner. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e926 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Jason M. Scovell More articles by this author Kieran Lewis More articles by this author Eran Maina More articles by this author Carlos Munoz-Lopez More articles by this author Steven C. Campbell More articles by this author Expand All Advertisement PDF downloadLoading ...