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MP22-01 PERIOPERATIVE MORBIDITY, ONCOLOGICAL OUTCOMES AND PREDICTORS OF PT3A UPSTAGING FOR PATIENTS UNDERGOING PARTIAL NEPHRECTOMY FOR CT1 TUMORS
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THE JOURNAL OF UROLOGYâ
Vol. 197, No. 4S, Supplement, Friday, May 12, 2017
Kidney Cancer: Epidemiology & Evaluation/Staging I Moderated Poster 22 Friday, May 12, 2017
3:30 PM-5:30 PM
MP22-01 PERIOPERATIVE MORBIDITY, ONCOLOGICAL OUTCOMES AND PREDICTORS OF PT3A UPSTAGING FOR PATIENTS UNDERGOING PARTIAL NEPHRECTOMY FOR CT1 TUMORS Pascal Mouracade*, Onder Kara, Julien Dagenais, Matthew Maurice, Ryan Nelson, Ercan Malkoc, Jaya Sai Chavali, Jihad Kaouk, Cleveland, OH INTRODUCTION AND OBJECTIVES: The question of whether upstaged and nonupstaged tumors have different outcomes continue to be discussed in the literature. Few published studies address this question, with a wide range of results. The aim of this study was to evaluate perioperative morbidity, oncological outcome and predictors of pT3a upstaging after partial nephrectomy(PN). METHODS: Retrospective study of 1042 patients who underwent PN for cT1 renal cell carcinoma between 2007 and 2015. A total of 113 cT1 patients were upstaged to pT3a, while 929 were staged pT1. Demographic, perioperative and pathological variables were reviewed. We compared the clinico-pathological characteristics, perioperative morbidity and oncological outcomes between pT3a and pT1 groups. Multivariate regression evaluates variables associated with T3a upstaging. Progression-free survival (PFS) and overall survival analyses were performed. RESULTS: pT3a tumors had a higher R.E.N.A.L score, higher hilar location, higher grade, and higher positive surgical margins. Patients with pT3a had a higher estimated blood loss, transfusion rate, ischemia time, overall complications, while there were no difference in median e-GFR decline and major (Grade III-V) complications. Five-year PFS was 78.5% for pT3a group, vs 94.6% for pT1 group (Log rank p <0.01). Male gender (OR 2.2, p<0.01), and R.E.N.A.L score (OR 2.3, p¼0.01) were preoperative predictors of upstaging. CONCLUSIONS: Perioperative morbidity is acceptable in pT3 tumors, however upstaged patients had a worse oncological outcomes. cT1/pT3a tumors are associated with adverse clinico-pathological features. Preoperative risk predictors of upstaging were, higher R.E.N.A.L score and male gender.
Source of Funding: None
MP22-02 SYNERGISTIC PROGNOSTIC IMPACT OF ELEVATED DE RITIS RATIO AND RENAL SCORE FOR PREDICTION OF SURVIVAL OUTCOMES IN RENAL CELL CARCINOMA AFTER SURGICAL TREATMENT Aaron Bloch, Zachary Hamilton*, Charles Field, Katherine Fero, Sean Berquist, Abd-elrahma Hassan, Brittney Cotta, Daniel Han, Richmond Owusu, Sunil Patel, Fang Wan, James Proudfoot, Ithaar Derweesh, San Diego, CA INTRODUCTION AND OBJECTIVES: Renal Cell Carcinoma (RCC) is a metabolically driven neoplasm. Inflammatory markers and
THE JOURNAL OF UROLOGYâ
Vol. 197, No. 4S, Supplement, Friday, May 12, 2017
Kidney Cancer: Epidemiology & Evaluation/Staging I Moderated Poster 22 Friday, May 12, 2017
3:30 PM-5:30 PM
MP22-01 PERIOPERATIVE MORBIDITY, ONCOLOGICAL OUTCOMES AND PREDICTORS OF PT3A UPSTAGING FOR PATIENTS UNDERGOING PARTIAL NEPHRECTOMY FOR CT1 TUMORS Pascal Mouracade*, Onder Kara, Julien Dagenais, Matthew Maurice, Ryan Nelson, Ercan Malkoc, Jaya Sai Chavali, Jihad Kaouk, Cleveland, OH INTRODUCTION AND OBJECTIVES: The question of whether upstaged and nonupstaged tumors have different outcomes continue to be discussed in the literature. Few published studies address this question, with a wide range of results. The aim of this study was to evaluate perioperative morbidity, oncological outcome and predictors of pT3a upstaging after partial nephrectomy(PN). METHODS: Retrospective study of 1042 patients who underwent PN for cT1 renal cell carcinoma between 2007 and 2015. A total of 113 cT1 patients were upstaged to pT3a, while 929 were staged pT1. Demographic, perioperative and pathological variables were reviewed. We compared the clinico-pathological characteristics, perioperative morbidity and oncological outcomes between pT3a and pT1 groups. Multivariate regression evaluates variables associated with T3a upstaging. Progression-free survival (PFS) and overall survival analyses were performed. RESULTS: pT3a tumors had a higher R.E.N.A.L score, higher hilar location, higher grade, and higher positive surgical margins. Patients with pT3a had a higher estimated blood loss, transfusion rate, ischemia time, overall complications, while there were no difference in median e-GFR decline and major (Grade III-V) complications. Five-year PFS was 78.5% for pT3a group, vs 94.6% for pT1 group (Log rank p <0.01). Male gender (OR 2.2, p<0.01), and R.E.N.A.L score (OR 2.3, p¼0.01) were preoperative predictors of upstaging. CONCLUSIONS: Perioperative morbidity is acceptable in pT3 tumors, however upstaged patients had a worse oncological outcomes. cT1/pT3a tumors are associated with adverse clinico-pathological features. Preoperative risk predictors of upstaging were, higher R.E.N.A.L score and male gender.
Source of Funding: None
MP22-02 SYNERGISTIC PROGNOSTIC IMPACT OF ELEVATED DE RITIS RATIO AND RENAL SCORE FOR PREDICTION OF SURVIVAL OUTCOMES IN RENAL CELL CARCINOMA AFTER SURGICAL TREATMENT Aaron Bloch, Zachary Hamilton*, Charles Field, Katherine Fero, Sean Berquist, Abd-elrahma Hassan, Brittney Cotta, Daniel Han, Richmond Owusu, Sunil Patel, Fang Wan, James Proudfoot, Ithaar Derweesh, San Diego, CA INTRODUCTION AND OBJECTIVES: Renal Cell Carcinoma (RCC) is a metabolically driven neoplasm. Inflammatory markers and