e442 THE JOURNAL OF UROLOGY� Vol. 191, No. 4S, Supplement, Sunday, May 18, 2014

disease-specific survival compared with solid CCRCC. Patientswith Cystic RCC are more commonly younger, African-Americanand female. These data support findings from small case seriesthat Cystic RCC has a more favorable course compared withsolid CCRCC.

Source of Funding: None

MP40-19ROLE OF MRI IN INDETERMINATE RENAL MASS: DIAGNOSTICACCURACY AND IMPACT ON CLINICAL DECISION MAKING

Taekmin Kwon*, In Gab Jeong, Dalsan You, Bumjin Lim,Donghyun Lee, Chunwoo Lee, Kyung-Sik Han, Seoul, Korea,Republic of; Sungwoo Hong, Cheonan, Korea, Republic of;Jun Hyuk Hong, Myung-Soo Choo, Hanjong Ahn, Tai Young Ahn,Choung-Soo Kim, Seoul, Korea, Republic of

INTRODUCTION AND OBJECTIVES: Magnetic resonanceimaging (MRI) is a diagnostic imaging method that can be used toassess indeterminate renal masses on computed tomography (CT).However, the diagnostic accuracy of MRI differs depending on thetype of the benign tumor. In addition, the ability of MRI to distinguishbetween renal cell carcinoma (RCC) and benign renal masses hasnot been fully evaluated. Therefore, we evaluated the diagnostic ac-curacy of magnetic resonance imaging (MRI) in distinguishing renalcell carcinoma (RCC) from indeterminate renal masses on computedtomography (CT) and investigated the impact of MRI on clinical de-cision making.

METHODS: A retrospective study was conducted in 120 pa-tients who performed MRI to distinguish RCC from indeterminate renalmass on CT. The diagnostic accuracy of CT and MRI was compared,and factors associated with a final diagnosis of RCC were evaluatedusing multivariate logistic regression analysis.

RESULTS: Of the 120 patients, 47 (39.2%) had benignmasses, including 32 (26.7%) AMLs, five (4.2%) oncocytomas and10 (8.3%) complicated cysts. The specificity of MRI was significantlysuperior to that of CT in diagnosing RCC (68.1% vs. 27.7%,p¼0.001), whereas the sensitivity was equivalent (91.8% vs. 94.5%,p¼0.754). Multivariate analysis showed that, female gender (oddsratio [OR]; 0.11, p<0.001) and MRI diagnosis of RCC (OR 23.35,p<0.001) were independently associated with a final diagnosis ofRCC. MRI results showed that 15 patients thought to have RCC onCT could have avoided unnecessary surgery, whereas three pa-tients thought to have benign masses on CT could have undergoneappropriate surgery.

CONCLUSIONS: MRI has incremental benefit to distinguishRCC from indeterminate renal mass on CT. The use of MRI may help toguide treatment and avoid unnecessary surgery in some patients.These results suggest that MRI can play an important role in deter-mining the most appropriate management strategy for patients withindeterminate renal masses detected by CT.

Source of Funding: none

MP40-20THE ASSOCIATION BETWEEN METABOLIC SYNDROME WITHTUMOR SIZE AND GRADE OF RENAL CELL CARCINOMA

Alper Otunctemur, Suleyman Sahin, Murat Dursun, Huseyin Besiroglu,Ismail Koklu, Mustafa Erkoc, Eyyup Danis, Muammer Bozkurt,Emin Ozbek*, Istanbul, Turkey

INTRODUCTION AND OBJECTIVES: Metabolic syndrome(MetS) is a multifactorial disease characterized by impaired glucosetolerance / diabetes, obesity, high triglyceride levels, low HDL levels,and hypertension. In this study we evaluated the relationship betweentumor size and grade of renal cell carcinoma in patients with meta-bolic syndrome.

METHODS: Between 2007-2013, 310 patients underwentradical nephrectomy for renal tumors and pathology reported renal cellcarcinoma enrolled in the study. The patients were divided into twogroups with and without metabolic syndrome. Diagnosis of metabolicsyndrome was based on National Cholesterol Education Program(NCEP) Adult Treatment Panel III (ATP III) criteria. The relationshipbetween tumor size and grade of the two groups (Fuhrman grade) wereevaluated statisticaly.

RESULTS: Metabolic syndrome was found in 70 patients.The mean age of patients with MetS group was 65.5 (40-87) andnon-MetS group was 58.8 (31-84) years. In MetS group we deter-mined over 7 cm tumor size in %55 of patients and over fuhrman 3tumor grade in %57 of patients. In non- MetS group we determinedover 7 cm tumor size in %35 of patients and over fuhrman 3 tumorgrade in %32 of patients. Patients with MetS compared to patientswithout MetS, tumor size and grade were detected significantlyhigher (p<0,05).

CONCLUSIONS: Renal cancer remains more aggressive inpatients with metabolic syndrome. Lifestyle and risk factors wererevealed significant for renal cancer patients.

Source of Funding: none