Pd46-10 Developing an Objective Scoring System to Stratify Patients With Small Renal Masses Into Those Most Suitable for Primary Treatment and Active Surveillance
Year: 2016
Type: article
Study design: Observational Study
Abstract: You have accessJournal of UrologyKidney Cancer: Localized: Ablative Therapy & Active Surveillance1 Apr 2016PD46-10 DEVELOPING AN OBJECTIVE SCORING SYSTEM TO STRATIFY PATIENTS WITH SMALL RENAL MASSES INTO THOSE MOST SUITABLE FOR PRIMARY TREATMENT AND ACTIVE SURVEILLANCE Ayodeji E. Sotimehin, Mark Riffon, Mark W. Ball, Michael A. Gorin, Michael H. Johnson, Christian P. Pavlovich, Mohammad E. Allaf, and Phillip M. Pierorazio Ayodeji E. SotimehinAyodeji E. Sotimehin More articles by this author , Mark RiffonMark Riffon More articles by this author , Mark W. BallMark W. Ball More articles by this author , Michael A. GorinMichael A. Gorin More articles by this author , Michael H. JohnsonMichael H. Johnson More articles by this author , Christian P. PavlovichChristian P. Pavlovich More articles by this author , Mohammad E. AllafMohammad E. Allaf More articles by this author , and Phillip M. PierorazioPhillip M. Pierorazio More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2402AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Despite increased detection and treatment of early-stage 1a (< or = 4cm) kidney cancer, mortality rates have remained stable. Active surveillance (AS) is an attractive management strategy for patients with small renal masses, but there remains a lack of objective selection criteria. Our aim is to develop objective selection criteria from existing literature and experience with our registry and generate an objective scoring system that can select patients best suited for AS. METHODS From 2009 to 2015, data from 535 patients enrolled in the Delayed Intervention and Surveillance for Small Renal Masses (DISSRM) registry, which follows patients electing AS or primary intervention for cancer specific survival (CSS) was analyzed. Demographic and clinical characteristics, including cancer specific information and comorbidities, were compared between the two groups using t test and chi-square testing as appropriate. Objective criteria were developed a priori based on evidence at the initiation of the registry and were modified as experience was gained. The DISSRM Score was developed from the most predictive combination of factors associated with increased suitability for AS. RESULTS Of the 535 patients, 253 (47%) selected active surveillance and 282 (53%) underwent primary intervention. AS patients were older, had worse CCI scores, and had more cardiovascular and total comorbidities. Points were assigned for age, modified-cardiovascular-index, dementia, and R.E.N.A.L-nephrometry score. With a maximum score of 8, the average DISSRM score was 2.09 in the AS cohort and 1.19 for PI patients. Notably, 80% of the patients in the PI arm had a score < or =2, compared to 30% in AS. The DISSRM Score achieved an AUC of 0.701. CONCLUSIONS The DISSRM Score is a useful objective scoring method to differentiate patients with SRM most suitable for AS. Although prospective validation is required, the DISSRM score may act as an easy-to-calculate surrogate for competing risk mortality in patients with SRM. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1127-e1128 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Ayodeji E. Sotimehin More articles by this author Mark Riffon More articles by this author Mark W. Ball More articles by this author Michael A. Gorin More articles by this author Michael H. Johnson More articles by this author Christian P. Pavlovich More articles by this author Mohammad E. Allaf More articles by this author Phillip M. Pierorazio More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2325129480