Abstracts from the Abstracts from the Mid-Atlantic Section of the AUA 2021

© The Canadian Journal of Urology TM : International Supplement, October 2021 Moderated Poster Session 4: Kidney/Bladder/Penile/Testicular/ Adrenal Cancer MP4-01 Association of Tumor Size and Surgical Approach with Oncological Outcomes in Patients with Adrenocortical Carcinoma A. Castro Bigalli 1 , K. Ginsburg 1 , D. Perlman 2 , E. Handorf 1 , J. Schober 1 , D. Chen 1 , R. Greenberg 1 , R. Viterbo 1 , R. Uzzo 1 , A. Kutikov 1 , M. Smaldone 1 , A. Correa 1 1 Fox Chase Cancer Center, Philadelphia, PA, USA; 2 Wayne State University, Detroit, MI, USA Introduction and Objective: We investigated the oncological outcomes for patients withmasses ≤6 cm, 6-10 cm, and >10 cm in size treatedwithminimally invasive adrenalectomy (MIA) compared with open approach (OA). Methods: We reviewed theNational Cancer Database for patients undergoing adrenalectomy for cT1-3N0M0Adrenocortical Carcinoma (ACC) from2010 to 2017. We performed 1:1 nearest neighbor propensity score matching within each size strata to adjust for differences between patients treatedwith OAand MIA with regards to clinical T stage, age, race, sex, comorbidity score, and insurance type. We compared proportion of patients with positive surgical margins (PSM) using the chi-squared test and fit Cox proportional hazards models to test for an association between surgical approach and overall survival (OS) with and without adjusting for size. Results: After matching, the analytic cohort consisted of 428 patients, equally split between OA and MIA. Covariates were balanced between the cohort and within each size strata. A similar proportion of patients had PSM when treated with OA compared with MIA among all patients and within each size strata (Figure 1). Patients treated with MIA had similar OS in our Cox proportional hazards without and with adjusting for size (HR 1.15, 95% CI: 0.86-1.53, p=0.341 and HR 1.15, 95% CI 0.87-1.54, p0.329). Conclusions: Patients withACC had similar incidence of PSM and OS when treatedwith OAandMIA. Although not statistically significant, patients with masses >10 cmhad increased PSMwhen treatedwithOAvs. MIA. OAremains the standard of care for patients undergoing adrenalectomy for ACC; future investigations are needed to help inform guideline statements regarding the appropriate use of MIA vs. OA. Patient Perceptions of Pelvic Organ Prolapse Education Techniques E. Corley, K. Paulosky, M. Karsalia, P. Terse, A. Nemirovsky, R. Malik University of Maryland School of Medicine, Baltimore, MD, USA Introduction andObjective: Limited patient understanding due to challenges in physician-patient communication and inadequate patient education materials (PEMs) can result in poor outcomes after pelvic organ prolapse (POP) repair. Our objective was to identify the process by which patients learned about POP and review their perception of available educational tools. Methods: Patients with history of POP were recruited using ResearchMatch and invited to participate in a virtual semi-structured interview where they were shown a website, brochure, and video pertaining to POP. Information regarding patient preference for PEMs was obtained. The interviews were transcribed, coded, and qualitative data analysis was performed using grounded theory methodology. Results: Qualitative analysis of interviews of eleven participants averaging 54 years old yielded several preliminary themes including: insufficient information to guide treatment decisions, desire for multimodal and comprehensive information packets, lack of support, and an increase in self-advocacy mechanisms. Emerging concepts included: participants feeling uninformed and distrustful towards treatment options offered during their physician visits, participants preferring multi-modal materials as a supplemental guide to treatment decisions, and participants feeling isolated around their diagnosis which led to them become lost to follow up. As a result, they developed self-reliant strategies for making treatment decisions including the use of online resources, speaking with family and friends, and finding their own treatment options. Conclusions: Women with POP reported lack of information and support which resulted in the generation of self-coping mechanisms. This led to significant anxiety surrounding their diagnosis and treatment. Developing a reproducible methodology to create evidence-based PEMs will significantly decrease patient misinformation, apprehension, and use of inaccurate sources of information. MP3-13 24

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