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Journal of Urology ; 207(SUPPL 5):e169, 2022.
Article in English | EMBASE | ID: covidwho-1886483


INTRODUCTION AND OBJECTIVE: Nephrectomy and venous thrombectomy is a challenging procedure with potential morbidity and mortality. Despite the increasing use of immune checkpoint inhibitors (ICI) in the management of advanced renal cell carcinoma (RCC), data regarding the outcomes of venous thrombectomy following ICI is limited. We evaluated the feasibility and perioperative outcomes of nephrectomy and venous thrombectomy following ICIs. METHODS: Patients with locally advanced or metastatic RCC with venous thrombus undergoing nephrectomy following ICI therapy were evaluated in four high-volume US academic centers between June 2017 and June 2021. Clinical data, perioperative outcomes, and 90-day complications were recorded. RESULTS: Out of 79 patients who received post-ICI nephrectomy, 27 had venous thrombus. Median (IQR) age was 64 (55-71) years. ICI regimens were Nivolumab ± Ipilimumab (n=19), and Pembrolizumab± Axitinib (n=8). Nephrectomy was indicated following either a good clinical response to ICI (n=24) or as a palliative surgery (n=3). Venous thrombi levels are shown in Table-1. Among all patients, 26 (96%) underwent radical and 1 (4%) partial nephrectomy;12 (44.5%) open, 12 (44.5%) robotic and 3 (11%) laparoscopic. One robotic case converted electively to open. Vascular procedures included renal vein thrombectomy (n=6), IVC thrombectomy and primary repair (n=19), IVC patch repair (n=1), and suprarenal cavectomy (n=1). No intraoperative complications were reported. Nine patients showed no viable tumor in the thrombus, of whom 2 had complete response in the primary tumor as well (ypT0N0). 90-day complication rate was 33% (n=9), with 8 patients (30%) requiring readmission (Table-2). One death was reported within 90 days due to COVID-19 infection. CONCLUSIONS: Nephrectomy and venous thrombectomy following systemic immune checkpoint inhibitor therapy is feasible. One third of patients show no viable tumor in the thrombus. Larger studies are needed to predict pathological response.

Journal of Urology ; 206(SUPPL 3):e190-e191, 2021.
Article in English | EMBASE | ID: covidwho-1483589


INTRODUCTION AND OBJECTIVE: To determine criteria of interest to Urology residency program directors (PDs) when selecting applicants for residency interviews during the COVID-19 pandemic. METHODS: An anonymous survey was sent via email to all Urology residency PDs across the United States. PDs were asked to assign the degree of importance (1-5, with 5 being very important) of selected factors in deciding which applicants to interview. Surveys were distributed and study data was managed using REDCap. Descriptive statistical analyses were performed. RESULTS: In total, 130 urology residency PDs were contacted and 64 (49.3%) responded to the survey. Urology letter(s) of recommendation (LOR) based on non-virtual rotation(s), Urology clerkship grades, research experience, and Visa status of the applicant were cited as the most important factors in selecting applicants for interview with median importance ratings of 5, 4, 4, and 5, respectively. Urology LOR based on virtual rotation(s), virtual subinternship( s), and participation in social media activities were the least important in selecting applicants for interviews with median importance ratings of 2 for each. Notably, Urology LOR(s) based on non-virtual rotation(s) and Visa status were consistently ranked as the most important factors by over 50% of PDs. CONCLUSIONS: Urology PDs value urology LOR(s) from nonvirtual rotation(s), Urology clerkship grades, research experience, and applicant Visa status as the most important factors in selecting applicants for interviews during the COVID-19 pandemic. Virtual rotation(s) and social media activity were ranked the lowest among criteria that influence the selection process for interviews.