Cancer - Kidney(구연) Oral Session 7 / Cancer - Kidney (Ⅰ) (O-077) Rm.201 10월 30일(수) 16:00-17:00 Impact of short warm ischemic time on renal function after partial nephrectomy for renal cell carcinoma in patients with pre-existing chronic kidney disease stage III: a multiinstitutional study 1인제대학교 해운대백병원, 2분당서울대학교병원, 3서울대학교병원, 4가톨릭대학교 서울성모병원, 5충북대학교병원, 6고려대학교 안암병원, 7국립암센터, 8칠곡경북대학교병원, 9화순전남대학교병원 Jae-Seung Chung1,Sung Kyu Hong2 Sang Chul Lee2, Chang Wook Jeong3, Cheol Kwak3, Hyeon Hoe Kim3, Sung Hoo Hong4, Yong June Kim5, Seok Ho Kang6, Jinsoo Chung7, Tae Gyun Kwon8, Eu Chang Hwang9, Seok-Soo Byun2. Introduction: The benefit of short warm ischemic time (WIT) in partial nephrectomy (PN) is still under debate. Especially, little is known about the effect of such ischemia on long-term renal function after PN in patients with chronic kidney disease (CKD). We evaluate longitudinal renal function after PN according to warm ischemic time (WIT) in patients with CKD stage III. Patients and Methods: We studied 2857 patients who underwent PN for renal cell carcinoma between 2004 and 2017. A total of 277 patients who underwent PN with CKD stage III (estimated glomerular filtration rate [eGFR] of 30-60 ml/min/1.73 m2) were identified. Patients were divided into two subgroups (Group A: 0≤WIT<25, Group B: 25≤WIT). We used 1:1 propensity score matching to adjust for age, gender, tumor size, comorbidities (diabetes, hypertension) and baseline renal function (eGFR). We compared the serial renal function between the two groups. The probabilities of freedom from CKD stage IV (eGFR < 30 ml/min/1.73 m2) and Overall survival (OS) rate were evaluated using the Kaplan-Meier method. Results: After propensity matching, 85 group A patients were matched with 85 group B patients. The median follow-up duration in the group A and B were 49 (IQR,13-83) and 42 (IQR,11-68) months, respectively. The median pre-eGFRs were 52.4 and 52.6 ml/min/1.73 m2 in each arm (Group A vs. Group B). There were no significant differences in renal function between the two groups, regardless of the entire postoperative period (all P>0.05). The 5-year CKD IV-free survival rates after surgery were not significantly different between the two groups. The incidence of new onset CKD stage IV were 8.2% (group A) and 7.1% (group B). The probabilities of freedom from CKD IV after PN were 90.4% for group A versus 86.8% for group B (P=0.229). In Cox hazards models for CKD stage IV, group A was not significantly different compared with group B (hazard ratio [HR],0.527; 95% CI, 0.183-1.521; P=0.236). Furthermore, The 5-year OS rates were 90.3% for group A versus 96.2% for group B. (P=0.549) Conclusions: Our data suggest that short WIT has no beneficial effect on renal function and survival rate after PN in patients with pre-existing CKD stage III. keywords : Renal Cell; Survival; Nephrectomy