In the last years the incidence of renal neoplasms has been steadily increasing, along with the average age of patients at the time of diagnosis. Surgical management for localized disease is becoming more challenging because of patients’ frailty. We conducted a multi-center prospective study to evaluate the role of the G8 as a screening tool in the assessment of intra and post-operative complications of elderly patients (≥70 y.o.) undergoing surgery for kidney cancer. A total of 162 patients were prospectively enrolled between January 2015 to January 2019 and divided into two study groups (frail vs. not-frail) according to their geriatric risk profile based on G8 score. Several factors (i.e., age, CCI, ASA score, preoperative anemia, RENAL score, surgical procedures, and techniques) were analyzed to identify whether any of them would configure as a statistically significant predictor of surgical complications. According to the G8 Score, 90 patients were included in the frail group. A total of 52 frail patients vs. 4 non-frail patients developed a postoperative complication of any kind (p < 0.001). Of these, 11 were major complications and all occurred in the frail group. Our results suggest that the G8 screening tool is an effective and useful instrument to predict the risk of overall complications in elderly patients prior to renal surgery.

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Background and Objectives: To assess efficacy and safety of Percutaneous Cryoablation (PCA) of small renal masses (SRMs) using Trifecta outcomes in a large cohort of patients who were not eligible for surgery. Materials and methods: All PCAs performed in four different centers between September 2009 and September 2019 were retrospectively evaluated. Patients were divided in two different groups depending on masses dimensional criteria: Group-A: diameter ≤ 25 mm and Group-B: diameter > 25 mm. Complications rates were reported and classified according to the Clavien–Dindo system. The estimate glomerular filtration rate (eGFR) was calculated before PCA and during follow-up schedule. Every patient received a Contrast Enhanced Ultrasound (CEUS) evaluation on the first postoperative day. Radiological follow-up was taken at 3, 6, and 12 months for the first year, then yearly. Radiological recurrence was defined as a contrast enhancement persistence and was reported in the study. Finally, Trifecta outcome, which included complications, RFS, and preservation of eGFR class, was calculated for every procedure at a median follow-up of 32 months. Results: The median age of the patients was 74 years. Group-A included 200 procedures while Group-B included 140. Seventy-eight patients were eligible for Trifecta evaluation. Trifecta was achieved in 69.6% of procedures in Group-A, 40.6% in Group-B (p = 0.02). We observed an increased rate of complication in Group-B (13.0% vs. 28.6; p < 0.001). However, 97.5% were <II Clavien–Dindo grade. No differences were found between the two groups regarding eGFR before and after treatment. Further, 24-months RFS rates were respectively 98.0% for Group-A and 92.1% in Group-B, while at 36 months were respectively 94.5% and 87.5% (p = 0.08). Conclusions: PCA seems to be a safe and effective treatment for SRM but in the need of more strict dimensional criteria to achieve a higher possible success rate.

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PURPOSE Urolithiasis is a worldwide spread condition that affect patients’ Health Related Quality of Life (HRQOL), which measurement is an important tool for routinary clinical and research practice. Disease-specific HRQOL measures demonstrated to perform better in assessing effects of specific conditions. A disease-specific questionnaire for kidney stones, the WISQOL, has been validated in different language, but an Italian version is still missing. Our aim is to produce and validate the Italian version of WISQOL (IT-WISQOL). METHODS Patients undergoing any elective treatment for upper urinary tract stones were enrolled. A multi-step process with forward- and back-translation was used to translate WISQOL to Italian. Patients were evaluated within 15 days pre-operatively and then at 1-,3-months post-operatively and administered both IT-WISQOL and SF-36v2. Post-operative data such as 30 days post-operative complications, late stone-related events, stone free status, stone complexity were collected. Cronbach’s αwas used to evaluate internal consistency of IT-WISQOL, while Spearman’s rho was used for item and inter-domain correlations and IT-WISQOL with SF-36v2 correlation. RESULTS We found excellent internal consistency across all domains (α ≥ 0.88), particularly when the total score is considered (α = 0.960). Test–retest reliability showed excellent results for the total questionnaire (Pearson correlation value: 0.85). the Inter-domain association ranged from 0.497 to 0.786. Convergent validity was con­firmed by a good correlation with subdomains of the SF-36v2 measures. CONCLUSION IT-WISQOL is a reliable tool to measure HRQOL in stone patients. It shows analogue characteristics if compared to English WISQOL.

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