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

MA-AUA 2021 Abstracts Moderated Poster Session 4: Kidney/Bladder/Penile/Testicular/ Adrenal Cancer Distribution of NewRenal Cell Carcinoma Cases Across a Large Statewide Cancer Registry A. Alzubaidi 1,2 , J. Fuletra 1,2 , J. Pham 1 , V. Walter 1 , M. Kaag 1,2 , S. Merrill 1,2 , J. Raman 1,2 1 Penn State College of Medicine, Hershey, PA, USA; 2 Penn State Health Medical Center, Hershey, PA, USA Introduction and Objective: Prior studies using nationwide databases have implicated an increased incidence of renal cell carcinoma (RCC) over time. Granular data, however, may highlight potential geographic regions enriched with disease. Therefore, we review 27-years of RCC within Pennsylvania to better define incidence, geographic distribution, and statewide trends. Methods: The Pennsylvania (PA) Cancer Registry was reviewed. R4.0.2 software was used to model average annual percent changes (AAPCs) in age-adjusted rates and map plots county-level distribution of stage and incidence of disease over 5-year intervals. Results: 59,628 cases were recorded from 1990 to 2017. (86%) were >50years of age, (61%)were males and (89%) were white. Stage distribution using SEER system: (64%) local, (17%) regional and (16%) distant. Over the study interval, age-adjusted rates of all cases increased from 9.9 to 18.0 patients per 100,000 with an AAPC of 2.3 (95%CI= (1.74,2.90), p<0.01) (Figure-1). Age-adjusted rates of local disease increased from 5.4 to 12.7 patients per 100,000 with an AAPC of 3.2 (95%CI=(2.93, 3.53), p <0.01). Age-adjusted rates of regional disease also increased from 1.9 to 2.9 patients per 100,000 with an AAPC of 1.0 (95%CI= (0.29,1.71), p=0.01). Younger patients (age <50 years) had a greater rate of increase than older (age>50 years) counterparts (APC: 3.8 vs. 2.0 ,respectively (p<0.05). Geospatial investigation noted certain geographic concentrations of greater disease incidence (Figure-2). Conclusions: The incidence of RCC has increased over the past 27-years, and this change is predominantly enriched with diagnosis of localized disease. Nonetheless, one-third of cases are regional or metastatic at presentation and rates of increase were most pronounced in younger patients. Geospatial investigation implicates growing “hot-spots” of RCC in certain portions of PA. MP4-15 Renal Functional Outcomes after Robotic Assisted Laparoscopic Partial Nephrectomy for Single vs Multiple Renal Tumors S. Kuppa, J. Lee, R. Raghavan, D. Eun Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA Introduction and Objective: Although there is established literature demonstrating renal function preservation of robotic assisted laparoscopic partial nephrectomy (RAPN) for multiple tumors, there is little data comparing the outcomes of simultaneous RAPN for multiple tumors to RAPN for a single tumor. We compare outcomes of multiple concomitant partial nephrectomies to those of single partial nephrectomy. Methods: We retrospectively reviewed our RAPNdatabase from2017 to 2020 to compare patient demographics and perioperative outcomes for patients who underwent single and multiple concomitant RAPN (Table 1). Patients undergoing repeat partial nephrectomy on the same kidney were excluded as were patients who had simultaneous surgery with RAPN. Results: Twenty-two patients with multiple concomitant partial nephrectomieswere compared to 84 patientswith single partial nephrectomies. Mean number of tumors resected in the multiple group was 2.27. There was no significant difference betweenmultiple and single RAPN groups in length of hospital stay, console time and estimated blood loss. The multiple and single RAPN groups had respective follow up from 13 and 42 patients with correspondingmean followup as 10.3months vs 8.01months. Themean eGFR change was not significantly different. The multiple group had significantly higher warm ischemia time and post-operative complication rate. However, the rates of Clavien III or higher postoperative complications were not significantly different between groups. No patients required intraoperative blood transfusions. Conclusions: Simultaneous RAPN for multiple tumors was associated with longer WIT andmore frequent post-operative complications. However, there was no difference between RAPN for multiple tumors and single tumors in console time, high-grade complication rate, length of stay, and renal functional outcomes. MP4-14 31