PD08-07 PREDICTIVE FACTORS FOR RECURRENCE AND OUTCOMES IN T1a RENAL CELL CARCINOMA: ANALYSIS OF THE INMARC (INTERNATIONAL MARKER CONSORTIUM FOR RENAL CANCER) DATABASE

You have accessJournal of UrologyCME1 Apr 2023PD08-07 PREDICTIVE FACTORS FOR RECURRENCE AND OUTCOMES IN T1a RENAL CELL CARCINOMA: ANALYSIS OF THE INMARC (INTERNATIONAL MARKER CONSORTIUM FOR RENAL CANCER) DATABASE Franklin Liu, Luke Wang, Sohail Dhanji, Margaret Meagher, Jonathan Afari, Cesare Saitta, Saeed Ghassemzadeh, Aastha Shah, Dhruv Puri, Mimi Nguyen, Kevin Hakimi, Benjamin Schmeusser, Rachel Greenwald, Alexandra Medline, Fatima Kamal, Adil Ali, Shohei Fukuda, Masaki Kobayashi, Wei Chen, Bo Fan, Yusuke Aida, Yuya Maezawa, Shintaro Asai, Hajime Tanaka, Dattatraya Patil, Yasuhisa Fujii, Viraj Master, and Ithaar Derweesh Franklin LiuFranklin Liu More articles by this author , Luke WangLuke Wang More articles by this author , Sohail DhanjiSohail Dhanji More articles by this author , Margaret MeagherMargaret Meagher More articles by this author , Jonathan AfariJonathan Afari More articles by this author , Cesare SaittaCesare Saitta More articles by this author , Saeed GhassemzadehSaeed Ghassemzadeh More articles by this author , Aastha ShahAastha Shah More articles by this author , Dhruv PuriDhruv Puri More articles by this author , Mimi NguyenMimi Nguyen More articles by this author , Kevin HakimiKevin Hakimi More articles by this author , Benjamin SchmeusserBenjamin Schmeusser More articles by this author , Rachel GreenwaldRachel Greenwald More articles by this author , Alexandra MedlineAlexandra Medline More articles by this author , Fatima KamalFatima Kamal More articles by this author , Adil AliAdil Ali More articles by this author , Shohei FukudaShohei Fukuda More articles by this author , Masaki KobayashiMasaki Kobayashi More articles by this author , Wei ChenWei Chen More articles by this author , Bo FanBo Fan More articles by this author , Yusuke AidaYusuke Aida More articles by this author , Yuya MaezawaYuya Maezawa More articles by this author , Shintaro AsaiShintaro Asai More articles by this author , Hajime TanakaHajime Tanaka More articles by this author , Dattatraya PatilDattatraya Patil More articles by this author , Yasuhisa FujiiYasuhisa Fujii More articles by this author , Viraj MasterViraj Master More articles by this author , and Ithaar DerweeshIthaar Derweesh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003239.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Stage migration in renal cell carcinoma (RCC) has led to an increasing proportion of diagnoses at earlier clinical tumor stage. While thought of as being low risk, emerging knowledge about heterogeneity of RCC histologies and consequent impact on prognosis led us to further explore outcomes and predictive factors in T1a RCC patients treated with surgical resection. METHODS: The INMARC database was queried for patients with T1aN0M0 RCC (≤4 cm) who underwent surgery via partial or radical nephrectomy. Patients were stratified into two groups based on having recurrence (distant or loco-regional) or not. Primary outcome was overall survival (OS). Multivariate analyses (MVA) were performed to analyze clinicopathological variables associated with recurrence and identify predictors of recurrence, cancer-specific mortality (CSM), and all-cause mortality (ACM). Kaplan-Meier analyses (KMA) were conducted for survival assessment between histology types clear cell, chromophobe, papillary, and variant. RESULTS: We analyzed 1,878 patients (median follow up 53.6 months); 101 (5.4%) developed recurrence (median time to recurrence 19.3 months); 51.1% developed distant recurrence, 35.6% had loco-regional recurrence, and 13.9% experienced distant and loco-regional recurrence. MVA demonstrated age (HR=1.02, p=0.02), sex (HR=1.71, p=0.045), diabetes (HR=1.94, p=0.006), high/unclassified grade (HR=2.82-4.40, p<0.001-0.007), papillary (HR=0.37, p=0.013) and variant (HR=2.51, p=0.019) RCC as predictive factors for recurrence. MVA identified high/unclassified grade (HR=3.17-6.22, p=0.002-0.003) and papillary RCC (HR=0.12, p=0.036) as predictive factors for CSM. MVA for ACM demonstrated age (HR=1.03, p<0.001), non-Caucasian race (HR=0.85, p<0.001), high grade (HR=1.42, p=0.024), recurrence (HR=1.86, p=0.003), and GFR<45 (HR=2.89, p<0.001) to be independent risk factors. KMA comparing clear cell, papillary, chromophobe and variant RCC revealed significant differences for 5-year CSS (97.8% vs. 99.3% vs. 98.5% vs. 87.0%, p=0.018) and 5-year RFS (92.4% vs. 96.0% vs. 97.8% vs. 81.7%, p<0.001), but not 5-year OS (89.4% vs. 85.2% vs. 93.2% vs. 73.7%, p=0.34). CONCLUSIONS: We noted differential outcomes in T1a RCC based on histology and grade for recurrence and CSM, while renal functional decline in addition to pathological factors and recurrence were predictive for ACM. These findings suggest consideration to refine management and post treatment surveillance strategies in T1a RCC. Source of Funding: Stephen Weissman Kidney Cancer Research Fund © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e235 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Franklin Liu More articles by this author Luke Wang More articles by this author Sohail Dhanji More articles by this author Margaret Meagher More articles by this author Jonathan Afari More articles by this author Cesare Saitta More articles by this author Saeed Ghassemzadeh More articles by this author Aastha Shah More articles by this author Dhruv Puri More articles by this author Mimi Nguyen More articles by this author Kevin Hakimi More articles by this author Benjamin Schmeusser More articles by this author Rachel Greenwald More articles by this author Alexandra Medline More articles by this author Fatima Kamal More articles by this author Adil Ali More articles by this author Shohei Fukuda More articles by this author Masaki Kobayashi More articles by this author Wei Chen More articles by this author Bo Fan More articles by this author Yusuke Aida More articles by this author Yuya Maezawa More articles by this author Shintaro Asai More articles by this author Hajime Tanaka More articles by this author Dattatraya Patil More articles by this author Yasuhisa Fujii More articles by this author Viraj Master More articles by this author Ithaar Derweesh More articles by this author Expand All Advertisement PDF downloadLoading ...