Session: PD40: Kidney Cancer: Localized: Surgical Therapy IV
PD40-12: Functional outcomes prediction after robotic partial nephrectomy using PADUA score assessed with 3D virtual models: preliminary results of a collaborative ERUS study
Introduction: 3D virtual models (3DVMs) already demonstrated their role in planning the strategy of robot- assisted partial nephrectomy (RAPN).Aim of this prospective observational study is to test their accuracy in assessing the tumor complexity in relationship with the functional outcomes Methods: Five European tertiary centers took part in the study, enrolling prospectively patients scheduled for RAPN from 06/2019 to 09/2022. The PADUA score of each renal mass undergoing surgery was assessed with 2D-imaging and 3DVMs.Baseline, postoperative (at discharge) and 3 rd month serum creatinine (SCr), estimated Glomerular Filtration Rate (eGFR) and Chronic kidney disease (CKD) category, were recorded and analyzed. Paired sample T-test was used to compare functional data. Finally, multivariable logistic analyses were built, looking for the predictors of worsening CKD category, including the Charlson-age-adjusted index, the PADUA score assessed with the two imaging tools and the intraoperative variables potentially impacting the functional outcome (renal pedicle management, type of tumor’s resection, violation of calyces and type of parenchymal suture) Results: 289 patients were included in the study. Median age, BMI and lesion size were 65 (55:73) yrs, 26 (23:29) and 32 (20:48) mm,respectively. Median PADUA scores, as calculated via 2D imaging and 3DVMs, resulted significantly different (p<0.001),being 8 (7:10) and 8 (7:9),respectively. Functional data are reported in Table 1. T-test showed significant differences between the preoperative and discharge values of SCr and eGFR (both p<0.001)while no differences in the same variables were found comparing the preoperative and 3 rd month values (p=0.09 and p=0.11). In 68/289 patients (23.5%) a worsening of CKD category was recorded.Multivariable analyses confirmed the 3DVM based-PADUA Score as the only independent predictor of worsening CKD category (OR;1.24 95%CI: 1.04-1.49, p=0.0151) Conclusions: In this multi-institutional study, 3DVMs resulted to be accurate in assessing the tumor complexity in relationship with the functional outcomes. Their use to evaluate the PADUA score was the only factor related to the postoperative worsening of CKD category SOURCE OF Funding: None
.jpg "Daniele Amparore, MD photo")
