MP59-16 COMPARATIVE EFFECTIVENESS OF LOCAL TUMOR DESTRUCTION VERSUS NEPHRECTOMY IN PATIENTS OLDER THAN 75 YEARS OLD FOR SMALL RENAL MASSES.

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You have accessJournal of UrologyKidney Cancer: Surgical Therapy III1 Apr 2015MP59-16 COMPARATIVE EFFECTIVENESS OF LOCAL TUMOR DESTRUCTION VERSUS NEPHRECTOMY IN PATIENTS OLDER THAN 75 YEARS OLD FOR SMALL RENAL MASSES. Maxine Sun, Alessandro Larcher, Zhe Tian, Shahrokh Shariat, Luc Valiquette, Fred Saad, and Pierre Karakiewicz Maxine SunMaxine Sun More articles by this author , Alessandro LarcherAlessandro Larcher More articles by this author , Zhe TianZhe Tian More articles by this author , Shahrokh ShariatShahrokh Shariat More articles by this author , Luc ValiquetteLuc Valiquette More articles by this author , Fred SaadFred Saad More articles by this author , and Pierre KarakiewiczPierre Karakiewicz More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2176AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recently, ablative techniques have gained popularity for treatment of small renal masses. Our objective was to conduct a comparative effectiveness study of local tumor destruction (LTD) vs. nephrectomy (both partial and radical). METHODS Relying on the Medicare-linked Surveillance, Epidemiology, and End Results database, elderly patients (≥75 years old) with a primary diagnosis of T1a renal cell carcinoma between years 2000-2009 were identified. Only those treated with LTD or partial/radical nephrectomy were included. Propensity-based matched analysis was performed to balance baseline patient and disease differences between the two treatment groups. Subsequently, Cox regression analyses were used for prediction of overall survival (OS) and competing-risks regression analyses were used for prediction of cancer-specific mortality (CSM). RESULTS Following propensity-matching, 244 LTD and 488 nephrectomy patients remained. Median follow-up was 27.7 months (median: 23). The 5-year OS rates for LTD was 61% vs. 69% for nephrectomy (log-rank P=0.5). Conversely, the 5-year CSM rates for the same groups were 8.7% vs. 3.7%, respectively (Gray test P=0.03). In Cox regression models for prediction of any death, no statistically significant difference between treatment groups was noted (hazard ratio [HR]: 1.11, 95% confidence interval [CI]: 0.67 to 1.83, P=0.7). In competing-risks regression models for prediction of CSM, treatment type remained non-significant (HR: 2.35, 95% CI: 0.84 to 6.45, P=0.1). CONCLUSIONS OS is virtually the same with either LTD or nephrectomy among elderly patients. Conversely, CSM appears to be more elevated when LTD is performed instead of nephrectomy. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e735-e736 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Maxine Sun More articles by this author Alessandro Larcher More articles by this author Zhe Tian More articles by this author Shahrokh Shariat More articles by this author Luc Valiquette More articles by this author Fred Saad More articles by this author Pierre Karakiewicz More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

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