JCU - Abstracts of the BAUS 2018 Scientific Meeting - June 2018 - 82

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Conclusions: Probability of treatment of T1 tumours
with PN increased with increasing hospital volume,
whereas an inverse association of hospital volume with
complication rate is found. These results show closer
guideline adherence in higher volume centers and support
the centralisation of specialist cancer surgical services to
improve patient outcomes.
P9-14 Outcomes in an octogenarian cohort
- a retrospective analysis of 15 years of
laparoscopic nephrectomies within a regional
centre
Norton S1, Murugappan S1, Hong M1, Grills R1
Hospital Geelong, Australia

1University

Introduction: Laparoscopic nephrectomy is the gold
standard for renal malignancies not amenable to nephron
sparing surgery. With an ageing population and increased
use of imaging modalities, the incidence of renal malignancies detected in the elderly has risen. Yet most cohort
studies only represent a small number of octogenarians.
We aimed to report our fifteen-year experience of performing laparoscopic nephrectomy in the elderly (t80yrs)
and compare their morbidity to younger patients.
Patients and Methods: All laparoscopic nephrectomies
performed across three institutions in a regional centre
over 15 years from 1/06/2001 to 31/6/2016 were identified through medical coding. Chart reviews were completed with documentation of age, BMI, operative details
including indication, blood loss and operative time. Postoperative complications were graded according to the
Clavien system.We excluded pyeloplasties, partial, open or
those converted to open nephrectomies.
Results: We identified 388 patients of median age 65yrs
(IQR53-74), of which 48 were octogenarians (t80yrs). No
patients underwent renal mass biopsy. The numbers of
benign pathologies were not different between the two
cohorts. Aside from age, no differences were apparent in
BMI (28 vs 28). Renal mass biopsies were not performed
on any patients. No statistically significant differences were
identified between octogenarians and non-octogenarians
in operative length (197mins vs 200), blood loss (197 vs
200mLs), complication rates (56% vs 38%, p 0.011) and
length of hospital stay (5 vs 5 days).
Conclusions: Our findings suggest that when octogenerians undergo laparoscopic nephrectomy, operative
characteristics, length of stay and complications rates
are comparable to their younger counterparts.
P9-15 Simultaneous cardiac and renal
surgery for renal and retroperitoneal
tumours invading the right atrium & peridiaphragmatic inferior vena cava: oncological
outcome & long-term survival

Journal of Clinical Urology 11(1S)
Warren H1, Fernando A1, Austin C1, Thomas K1,
Chowdhury S1, O'Brien T1
1Guy's & St Thomas' NHS Foundation Trust, London, United
Kingdom

Introduction: Simultaneous cardiac and renal surgery
for tumours invading the inferior vena cava up to the right
atrium is feasible but high risk. Given the risk and changing landscape of systemic therapy in renal cell cancer
(RCC) it is important to know contemporary oncological
outcomes.
Methods: Retrospective cohort study of patients referred
for simultaneous cardiac and renal surgery for renal and
retroperitoneal tumours. Cases identified from a prospective database collected 2007-2017. Perioperative data and
oncological follow-up were extracted from electronic
patient records. For patients lost to follow up, survival
data was obtained from GPs. We used Kaplan-Meier
curves to estimate overall and disease-free survival.
Results: 54 cases identified, 47 of whom underwent surgery. Mean age at operation 63 years (range 17-95).
Neves-Zincke classification of IVC thrombus: 62% level 4
(intra-atrial), 34% level 3 (hepatic veins), 4% stages 1&2.
12/47 had radiological evidence of metastasis at presentation. 3/47 patients (6%) died in the peri-operative period
and were excluded from further analysis. Histology confirmed 33 clear cell RCCs, six papillary cell RCCs and five
non-RCCs. Median post-operative survival was 30 months
(interquartile range 14.9 - upper quartile not reached). Of
the 12 who underwent cytoreductive surgery median
post-operative survival was 16.1 versus 32.7 months for
those treated with curative intent. Disease free survival
was 10.4 months (IQR 5.9 - 38.8) in those treated with
curative intent.
Conclusions: Median postoperative survival of 2.5 years
and relief of circulatory symptoms appears to justify surgery in patients with renal and retroperitoneal tumours
invading the heart.
P9-16 Investigation of the IMDC prognostic
model as a predictor of outcome from
cytoreductive nephrectomy in metastatic
renal cell carcinoma
Hendry J2, Beh I1, Clement K2, Leung S1, McNeill A1,
O'Connor K3, Riddick A4, Stewart G4, Qureshi K2,
Aboumarzouk O2, Oades G2, Laird A1
1NHS Lothian University Hospitals, Edinburgh, United Kingdom,
2Queen Elizabeth University Hospital, Glasgow, United Kingdom,
3Cork University Hospital, Ireland 4Addenbrooke's Hospital,
Cambridge, United Kingdom

Introduction: Selecting patients with metastatic renal cell
carcinoma (mRCC) for cytoreductive nephrectomy (CN)
can be difficult. The International mRCC Database
Consortium Prognostic Model (IMDC-M) aids stratification

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