JCU - Abstracts of the BAUS 2018 Scientific Meeting - June 2018 - 78

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Methods: We examined the BAUS data from 2014-16 for
NU patients with UTUC, comparing clinical to pathological stage, preoperative biopsy; renal function; and PS.
Results: Of 2217 with clinical and pathological staging,
the percentage pT2+ increased with increasing clinical
stage: cT1/a = 34.8%; cT2 = 67.8%; cT3 = 84.2%; and cT4
= 96.9%. Biopsy grading was reported in 1047 cases: G1 in
157; G2 in 477; G3 in 407 and G4 in 6. Combining G3
biopsy and cT2+ predicts pT2+ in 85%. eGFR was greater
than 60 ml/min in 39.8%; 40-60 in 47.3%; and less than 40
in 12.9%.The median eGFR was 58. PS was 0 in 41.3%; 1 in
43.6%; 2 in 13.5%; and 4 in 0.1%.
Conclusions: NAC is feasible in terms of preoperative
PS and eGFR.The accuracy of clinical staging alone is inadequate but is improved by G3 biopsy. Biopsies are currently performed in the minority of patients. Improvements
in imaging and tissue sampling are needed to improve clinical staging accuracy.
P9-10 The continuous evolution of robotic
assisted partial nephrectomy in complex
renal tumours: a selection rather than a
learning curve
De Luyk N1, Marconi L1, Namdarian B1, Lo
W1, Rajangam A1, Catterwell R1, Fernando A1,
Challacombe B1
1Guy's and St Thomas' Hospital NHS Foundation Trust, London,
United Kingdom
P9-10: Table 1

Journal of Clinical Urology 11(1S)
Introduction & Objectives: Robotic assisted partial
nephrectomy (RAPN) is the predominant method to treat
small renal masses. We analysed our results looking at
casemix with disease parameters and pertinent outcomes
of both operative and oncological variables.
Methods: We reviewed our prospectively collated database of 352 RAPN performed sequentially between 2010
and 2017. Cases were divided into 3 cohorts. Variables
included age, BMI, ASA, estimated GFR (eGFR), tumour
size, PADUA score, operative time, blood loss, warm
ischemic time (WIT), volume of healthy renal parenchyma
loss and length of stay (LOS). The renal Trifecta was
defined as WIT d25 minutes, negative surgical margins
and absence of Clavien t3a complications. Pentafecta was
defined as achievement of Trifecta with addition of over
90% eGFR preservation and no chronic kidney disease
(CKD) stage upgrade. Results were analysed using nonparametric analysis.
Results: 300 cases were included (with full data) with
clinical features below (Table 1). There was a steady
increase in patient and tumour complexity while our Tri
and Pentafecta rates increased over the cohorts.
Conclusion: Despite performing RAPN on more comorbid patients with greater BMI, poorer renal function, who
have larger more complex lesions, the Trifecta and Pentafecta
rates have climbed. LOS is shorter, renal function is maintained without a concomitant increase in WIT. In our experience this affirms the safety and feasibility of RAPN in more
complex patients with more complex pathology.

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