Mp69-12 the prediction of renal function change after unilateral nephroureterectomy in upper tract urothelial carcinoma patients by using tc-99m mag3 renal scan

You have accessJournal of UrologyCME1 Apr 2023MP69-12 THE PREDICTION OF RENAL FUNCTION CHANGE AFTER UNILATERAL NEPHROURETERECTOMY IN UPPER TRACT UROTHELIAL CARCINOMA PATIENTS BY USING TC-99M MAG3 RENAL SCAN Kai-Sen Su, Yi-Hsiu Huang, Ming-Hsuan Ku, Wei-Ren Chen, Tzu-Hao Huang, Tzu-Chun Wei, I-Shen Huang, Yu-Hua Fan, Chih-Chieh Lin, Tzu-Ping Lin, Hsiao-Jen Chung, Junne-Yih Kuo, Yen-Hwa Chang, Teng-Lung Lin, Jhih-Sian Huang, and Jen-Chieh Chen Kai-Sen SuKai-Sen Su More articles by this author , Yi-Hsiu HuangYi-Hsiu Huang More articles by this author , Ming-Hsuan KuMing-Hsuan Ku More articles by this author , Wei-Ren ChenWei-Ren Chen More articles by this author , Tzu-Hao HuangTzu-Hao Huang More articles by this author , Tzu-Chun WeiTzu-Chun Wei More articles by this author , I-Shen HuangI-Shen Huang More articles by this author , Yu-Hua FanYu-Hua Fan More articles by this author , Chih-Chieh LinChih-Chieh Lin More articles by this author , Tzu-Ping LinTzu-Ping Lin More articles by this author , Hsiao-Jen ChungHsiao-Jen Chung More articles by this author , Junne-Yih KuoJunne-Yih Kuo More articles by this author , Yen-Hwa ChangYen-Hwa Chang More articles by this author , Teng-Lung LinTeng-Lung Lin More articles by this author , Jhih-Sian HuangJhih-Sian Huang More articles by this author , and Jen-Chieh ChenJen-Chieh Chen More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003332.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radical nephroureterectomy with bladder cuff excision (RNU BCE) is the standard of treatment for high-risk upper tract urothelial carcinoma (UTUC). We aim to develop a predictive equation for post-unilateral RNU BCE renal function by using pre-operative renal scintigraphy. METHODS: From January 2010 to December 2020, patients diagnosed with UTUC and underwent unilateral RNU BCE in our institute were reviewed. Comprehensive renal function evaluation by technetium-99m mercaptoacetyltriglycine (Tc-99m MAG3) renal scintigraphy was done pre-operatively. Serum creatinine level was recorded pre-operatively, 3 months (3M) and 6 months (6M) post-operatively (OP). Pearson’s linear correlation analysis was used for developing predictive equation. Internal validation with patients of the same criteria recruited after the study period (2021’s database) was done to test the equation’s accuracy. Cisplatin ineligibility by renal function was defined as eGFR <60 ml/min/1.73m2. RESULTS: In total, 487 patients who underwent unilateral RNU BCE for UTUC were included. The median pre-operative total effective renal plasma flow (ERPF) was 241.30 ml/min, and the lesion side accounted for 35.6% of total ERPF. Pre-operative lesion side ERPF ratio was significantly associated to post-operative decrease of eGFR ratio at 3 months (R=0.613, p<0.001), and the predictive equation was established as: Post-OP 3M Decrease of eGFR (%)=0.675 x Lesion Side/Total ERPF Ratio (%)+0.919. Internal validation with 2021’s database showed high accuracy of prediction in post-OP 3M eGFR decrease (R=0.896). For the 12 patients that experienced RNU-related cisplatin ineligibility, our predictive equation successfully foresaw such renal function loss in all patients, with a prediction accuracy of 12/12 (100%). CONCLUSIONS: We established a predictive equation using pre-operative lesion side ERPF ratio to predict post-operative eGFR loss. Such an equation could accurately predict residual renal function and foresee RNU-related cisplatin ineligibility before unilateral RNU. Source of Funding: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e968 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kai-Sen Su More articles by this author Yi-Hsiu Huang More articles by this author Ming-Hsuan Ku More articles by this author Wei-Ren Chen More articles by this author Tzu-Hao Huang More articles by this author Tzu-Chun Wei More articles by this author I-Shen Huang More articles by this author Yu-Hua Fan More articles by this author Chih-Chieh Lin More articles by this author Tzu-Ping Lin More articles by this author Hsiao-Jen Chung More articles by this author Junne-Yih Kuo More articles by this author Yen-Hwa Chang More articles by this author Teng-Lung Lin More articles by this author Jhih-Sian Huang More articles by this author Jen-Chieh Chen More articles by this author Expand All Advertisement PDF downloadLoading ...