PD02-01 A NOVEL MULTIPLEX SCORE TO PREDICT OUTCOMES OF PARTIAL NEPHRECTOMY FOR MULTIPLE TUMORS Article Swipe

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Heather J. Chalfin , Nitin Yerram , Sandeep Gurram , W. Marston Linehan , Mark W. Ball ·

YOU? · · 2020 · Open Access · · DOI: https://doi.org/10.1097/ju.0000000000000822.01

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy I (PD02)1 Apr 2020PD02-01 A NOVEL MULTIPLEX SCORE TO PREDICT OUTCOMES OF PARTIAL NEPHRECTOMY FOR MULTIPLE TUMORS Heather Chalfin*, Nitin Yerram, Sandeep Gurram, W. Marston Linehan, and Mark Ball Heather Chalfin*Heather Chalfin* More articles by this author , Nitin YerramNitin Yerram More articles by this author , Sandeep GurramSandeep Gurram More articles by this author , W. Marston LinehanW. Marston Linehan More articles by this author , and Mark BallMark Ball More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000822.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The RENAL nephrometry score (RNS) is widely used to describe renal mass complexity and inform patient counseling for partial nephrectomy (PN). However, in cases with multiple lesions (commonly seen in hereditary cancer syndromes) it is unknown which features drive postoperative complications. Here, we employed a novel scoring equation (Multiplex Score, MS) derived from RNS and assessed outcomes of multiplex PN at our institution. METHODS: The MS was defined a priori as a weighted score (# low risk (LR) lesions) + 2*(# intermediate risk (IR)) + 4*(# high risk (HR)) based on published Clavien-Dindo III-V complication rates of 6.4%, 11.1%, and 21.9% for LR, IR, and HR RNS respectively. MS was dichotomized into favorable/unfavorable based on median score. Patient outcomes were maintained prospectively. Binary outcomes were evaluated with logistic regression and continuous outcomes were evaluated with linear regression. RESULTS: From 10/2017-8/2019, 62 consecutive multiplex PN (median (range) # tumors = 4 (2-11), 65% robotic) were performed by a single surgeon. Median (range) MS was 6 (2-20). Of 13 complications, urine leak (N=5, 8%) and bleed requiring embolization (N=4, 6%) were the most common. Only 1 complication occurred in the favorable score group and MS was significantly associated with perioperative complication (OR 1.21, p=0.018) and blood loss (242.42 mL, p<0.001). Hilar clamping was omitted in 32 (52%) cases with median 18.5 min when used. Every 1 additional HR or IR tumor was associated with a 2 minute increase in clamp time (2.01, p=0.048). Median clamp time for favorable/unfavorable cases was 0 vs. 10 minutes. Change in renal function was negligible in our cohort (median ΔCr 0 mg/dL, IQR -0.61 – 0.1). There were no conversions from partial to radical nephrectomy and open conversion was only done in 3 (7.5%) cases, all assigned unfavorable MS. CONCLUSIONS: The novel Multiplex Score associated well with complications, blood loss, and open conversion. This tool may facilitate standardized reporting of complexity for multiplex series, with special relevance for hereditary cancer syndromes. Source of Funding: This project has been funded with federal funds from the National Cancer Institute, National Institutes of Health © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e66-e66 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Heather Chalfin* More articles by this author Nitin Yerram More articles by this author Sandeep Gurram More articles by this author W. Marston Linehan More articles by this author Mark Ball More articles by this author Expand All Advertisement PDF downloadLoading ...

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Medicine

Wavelength-Division Multiplexing

Concepts

Medicine Nephrectomy Logistic regression Multiplex Surgery Internal medicine Oncology Bioinformatics Kidney Biology

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Type: article
Language: en
Landing Page: https://doi.org/10.1097/ju.0000000000000822.01
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Title: PD02-01 A NOVEL MULTIPLEX SCORE TO PREDICT OUTCOMES OF PARTIAL NEPHRECTOMY FOR MULTIPLE TUMORS

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Publication year: 2020

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Authors: Heather J. Chalfin, Nitin Yerram, Sandeep Gurram, W. Marston Linehan, Mark W. Ball

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Concepts: Medicine, Nephrectomy, Logistic regression, Multiplex, Surgery, Internal medicine, Oncology, Bioinformatics, Kidney, Biology

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abstract_inverted_index.author	45, 54, 63, 74, 84, 480, 487, 494, 502, 509
abstract_inverted_index.cancer	131, 422
abstract_inverted_index.cases,	387
abstract_inverted_index.cohort	360
abstract_inverted_index.funded	431
abstract_inverted_index.inform	114
abstract_inverted_index.linear	235
abstract_inverted_index.median	215, 317
abstract_inverted_index.mg/dL,	364
abstract_inverted_index.minute	334
abstract_inverted_index.priori	169
abstract_inverted_index.score.	216
abstract_inverted_index.single	257
abstract_inverted_index.tumors	247
abstract_inverted_index.widely	106
abstract_inverted_index.(2-11),	250
abstract_inverted_index.(2-20).	264
abstract_inverted_index.(242.42	305
abstract_inverted_index.(PD02)1	10
abstract_inverted_index.(median	244, 361
abstract_inverted_index.(range)	245, 260
abstract_inverted_index.Cancer:	5
abstract_inverted_index.Gurram,	31
abstract_inverted_index.Heather	26, 38, 474
abstract_inverted_index.Linehan	69, 497
abstract_inverted_index.Marston	33, 66, 68, 496
abstract_inverted_index.PARTIAL	21
abstract_inverted_index.PREDICT	18
abstract_inverted_index.Patient	217
abstract_inverted_index.Sandeep	30, 56, 488
abstract_inverted_index.Therapy	8
abstract_inverted_index.Yerram,	29
abstract_inverted_index.common.	281
abstract_inverted_index.defined	167
abstract_inverted_index.derived	151
abstract_inverted_index.e66-e66	459
abstract_inverted_index.federal	433
abstract_inverted_index.lesions	126
abstract_inverted_index.omitted	311
abstract_inverted_index.partial	118, 374
abstract_inverted_index.patient	115
abstract_inverted_index.project	428
abstract_inverted_index.radical	376
abstract_inverted_index.scoring	146
abstract_inverted_index.series,	416
abstract_inverted_index.special	418
abstract_inverted_index.unknown	135
abstract_inverted_index.203Issue	455
abstract_inverted_index.Abstract	96
abstract_inverted_index.American	447, 466
abstract_inverted_index.BallMark	78
abstract_inverted_index.Chalfin*	40, 475
abstract_inverted_index.Funding:	426
abstract_inverted_index.However,	121
abstract_inverted_index.Linehan,	34
abstract_inverted_index.METHODS:	163
abstract_inverted_index.MULTIPLE	24
abstract_inverted_index.National	437, 440
abstract_inverted_index.OUTCOMES	19
abstract_inverted_index.RESULTS:	237
abstract_inverted_index.Surgical	7
abstract_inverted_index.ToolsAdd	89
abstract_inverted_index.articles	42, 51, 60, 71, 81, 477, 484, 491, 499, 506
abstract_inverted_index.assessed	155
abstract_inverted_index.assigned	389
abstract_inverted_index.clamping	309
abstract_inverted_index.describe	109
abstract_inverted_index.employed	143
abstract_inverted_index.equation	147
abstract_inverted_index.features	137
abstract_inverted_index.function	355
abstract_inverted_index.increase	335
abstract_inverted_index.lesions)	178
abstract_inverted_index.logistic	227
abstract_inverted_index.minutes.	351
abstract_inverted_index.multiple	125
abstract_inverted_index.occurred	285
abstract_inverted_index.outcomes	156, 218, 223, 231
abstract_inverted_index.p=0.018)	301
abstract_inverted_index.robotic)	252
abstract_inverted_index.surgeon.	258
abstract_inverted_index.weighted	172
abstract_inverted_index.(commonly	127
abstract_inverted_index.2020Page:	458
abstract_inverted_index.Chalfin*,	27
abstract_inverted_index.Copyright	461
abstract_inverted_index.Education	450, 469
abstract_inverted_index.LinehanW.	67
abstract_inverted_index.MULTIPLEX	15
abstract_inverted_index.Multiplex	395
abstract_inverted_index.Research,	452, 471
abstract_inverted_index.evaluated	225, 233
abstract_inverted_index.favorable	288
abstract_inverted_index.multiplex	158, 242, 415
abstract_inverted_index.p<0.001).	307
abstract_inverted_index.p=0.048).	340
abstract_inverted_index.performed	254
abstract_inverted_index.published	191
abstract_inverted_index.relevance	419
abstract_inverted_index.reporting	411
abstract_inverted_index.requiring	274
abstract_inverted_index.(Multiplex	148
abstract_inverted_index.Institute,	439
abstract_inverted_index.Institutes	441
abstract_inverted_index.Localized:	6
abstract_inverted_index.OBJECTIVE:	99
abstract_inverted_index.Supplement	456
abstract_inverted_index.Urological	448, 467
abstract_inverted_index.additional	324
abstract_inverted_index.associated	295, 330, 397
abstract_inverted_index.complexity	112, 413
abstract_inverted_index.continuous	230
abstract_inverted_index.conversion	380
abstract_inverted_index.counseling	116
abstract_inverted_index.facilitate	409
abstract_inverted_index.hereditary	130, 421
abstract_inverted_index.maintained	220
abstract_inverted_index.negligible	357
abstract_inverted_index.regression	228
abstract_inverted_index.syndromes)	132
abstract_inverted_index.syndromes.	423
abstract_inverted_index.2020PD02-01	12
abstract_inverted_index.Association	449, 468
abstract_inverted_index.Information	473
abstract_inverted_index.NEPHRECTOMY	22
abstract_inverted_index.YerramNitin	48
abstract_inverted_index.consecutive	241
abstract_inverted_index.conversion.	405
abstract_inverted_index.conversions	372
abstract_inverted_index.nephrectomy	119, 377
abstract_inverted_index.nephrometry	102
abstract_inverted_index.regression.	236
abstract_inverted_index.unfavorable	390
abstract_inverted_index.CONCLUSIONS:	392
abstract_inverted_index.INTRODUCTION	97
abstract_inverted_index.complication	194, 284, 298
abstract_inverted_index.dichotomized	210
abstract_inverted_index.embolization	275
abstract_inverted_index.institution.	162
abstract_inverted_index.intermediate	181
abstract_inverted_index.standardized	410
abstract_inverted_index.Advertisement	460, 512
abstract_inverted_index.Clavien-Dindo	192
abstract_inverted_index.GurramSandeep	57
abstract_inverted_index.Permissions©	463
abstract_inverted_index.UrologyKidney	4
abstract_inverted_index.accessJournal	2
abstract_inverted_index.perioperative	297
abstract_inverted_index.postoperative	139
abstract_inverted_index.respectively.	207
abstract_inverted_index.significantly	294
abstract_inverted_index.CitationsTrack	92
abstract_inverted_index.InTwitterEmail	95
abstract_inverted_index.complications,	267, 400
abstract_inverted_index.complications.	140
abstract_inverted_index.prospectively.	221
abstract_inverted_index.10/2017-8/2019,	239
abstract_inverted_index.Chalfin*Heather	39
abstract_inverted_index.downloadLoading	514
abstract_inverted_index.Inc.MetricsAuthor	472
abstract_inverted_index.favoritesDownload	91
abstract_inverted_index.ShareFacebookLinked	94
abstract_inverted_index.favorable/unfavorable	212, 345
abstract_inverted_index.CitationsPermissionsReprints	93
abstract_inverted_index.Inc.FiguresReferencesRelatedDetails	453
abstract_inverted_index.Informationhttps://doi.org/10.1097/JU.0000000000000822.01AboutPDF	88
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