Pd11-12 Outcomes for Localized Renal Cell Carcinoma Patients on Immunosuppression Following Solid Organ Transplantation

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy I (PD11)1 May 2024PD11-12 OUTCOMES FOR LOCALIZED RENAL CELL CARCINOMA PATIENTS ON IMMUNOSUPPRESSION FOLLOWING SOLID ORGAN TRANSPLANTATION Andrew Z. Carey, Edwin J. Abel, Brendan Dolan, Joshua Mezrich, David Al-Adra, David Aufhauser, Kelly M. Collins, Didier Mandelbrot, Sandesh Parajuli, Glenn O. Allen, David F. Jarrard, Kyle A. Richards, Michael Risk, and Daniel D. Shapiro Andrew Z. CareyAndrew Z. Carey , Edwin J. AbelEdwin J. Abel , Brendan DolanBrendan Dolan , Joshua MezrichJoshua Mezrich , David Al-AdraDavid Al-Adra , David AufhauserDavid Aufhauser , Kelly M. CollinsKelly M. Collins , Didier MandelbrotDidier Mandelbrot , Sandesh ParajuliSandesh Parajuli , Glenn O. AllenGlenn O. Allen , David F. JarrardDavid F. Jarrard , Kyle A. RichardsKyle A. Richards , Michael RiskMichael Risk , and Daniel D. ShapiroDaniel D. Shapiro View All Author Informationhttps://doi.org/10.1097/01.JU.0001008604.95535.b9.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Transplant patients who develop localized renal cell carcinoma (RCC) have a theoretically higher risk of disease progression because of pharmacologic immunosuppression. This study compared outcomes for localized RCC patients who received a prior organ transplant to a matched cohort of non-transplant patients. METHODS: Patients were identified from a solid organ transplant database with tissue diagnosis of non-metastatic RCC after transplantation between 2000-2020. Transplant patients were matched 1:2 to non-transplant patients based on treatment type, age, grade, and tumor size. Clinical variables and survival outcomes were compared. RESULTS: A total of 81 patients were identified who developed non-metastatic RCC after organ transplant. Median age was 57 years and 27% were female. Management strategies included surgery (65%), thermal ablation (23%), and active surveillance (10%). Among active surveillance patients, 0/9 developed metastases and 4/9 died of non-RCC causes with median follow-up of 89 months. Papillary RCC was more common in the transplant than matched cohorts (41 vs 18%, p0.05 for all) (Figure 1C). Among surgical patients, median follow-up was 65 vs 90 months for transplant vs. non-transplant patients (N=54, 104); p=0.08. Transplant patients were more likely to have postoperative complications (p=0.04) (Table 1B). No difference was found in local recurrence, metastatic progression or overall survival (p>0.05 for all) (Figure 1D) Among all patients, multivariable Cox regression showed only Charlson comorbidity index was associated with mortality (HR 1.3, p<0.001) after adjusting for transplant status, age, grade, RCC subtype, and tumor size. CONCLUSIONS: Patients who develop non-metastatic RCC after solid organ transplantation have similar outcomes as non-transplant patients. Mortality is primarily associated with comorbidity and further studies should evaluate expanding the role of active surveillance for transplant patients with localized RCC. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e255 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Andrew Z. Carey More articles by this author Edwin J. Abel More articles by this author Brendan Dolan More articles by this author Joshua Mezrich More articles by this author David Al-Adra More articles by this author David Aufhauser More articles by this author Kelly M. Collins More articles by this author Didier Mandelbrot More articles by this author Sandesh Parajuli More articles by this author Glenn O. Allen More articles by this author David F. Jarrard More articles by this author Kyle A. Richards More articles by this author Michael Risk More articles by this author Daniel D. Shapiro More articles by this author Expand All Advertisement PDF downloadLoading ...