Mp36-01 Evaluating Sporadic Multifocal Tumors in a 10-Year Retrospective Analysis: Does Biggest Always Mean the Baddest?

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging/Surveillance I (MP36)1 May 2024MP36-01 EVALUATING SPORADIC MULTIFOCAL TUMORS IN A 10-YEAR RETROSPECTIVE ANALYSIS: DOES BIGGEST ALWAYS MEAN THE BADDEST? Shavy Nagpal, Dongling Wu, Olivia Kola, Jesse Pesily, Sameer Thakker, Fang Ming Deng, Katie Murray, and William Huang Shavy NagpalShavy Nagpal , Dongling WuDongling Wu , Olivia KolaOlivia Kola , Jesse PesilyJesse Pesily , Sameer ThakkerSameer Thakker , Fang Ming DengFang Ming Deng , Katie MurrayKatie Murray , and William HuangWilliam Huang View All Author Informationhttps://doi.org/10.1097/01.JU.0001008612.93052.9d.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: For unifocal kidney tumors, size and growth kinetics are predictive of malignant potential. Multifocal renal masses present a diagnostic and therapeutic challenge, as it is unclear if the largest (index) renal tumor is always indicative of the most aggressive tumor. We reviewed our renal tumor database to evaluate tumor concordance and predictors of aggressiveness in contemporary cohort of patients with sporadic multi-focal tumors. METHODS: We conducted a retrospective chart review at a tertiary referral center. Our study included patients undergoing nephrectomy (radical and partial) over a ten-year period, from January 2010 to December 2019 (n=1983) which were then screened for patients with multifocal renal tumors (n=138). Variables of interest included tumor size, grading, as well as radiographic and pathologic staging. Patients with syndromic disease such as Tuberous sclerosis, Birt-Hogg-Dube, Von Hippel-Lindau, etc., were excluded from the analysis (n=10), resulting in total sample of 128 patients with sporadic multifocal tumors. The ASSURE RCC Prognostic Nomogram was utilized to predict the risk of disease progression for each individual tumor. RESULTS: In our study of 128 patients, 82 (64%) demonstrated concordant histology amongst the multi-focal tumors. In 99 out of 128 patients (77.3%), index (larger) tumor predicted a more or equivocal aggressive behavior. 29 out of 128 (22.6%) patients had benign or low malignant potential index tumor. Among these, 9 out of 29 (31%) patients harbored malignant smaller tumor. CONCLUSIONS: In a contemporary series of sporadic multi-focal tumors, ∼1/3rd of tumors may have discordant histology, with malignant potential which may not correlate to size. While the index tumor tends to predict the greatest oncologic risk, a considerable number of patients will harbor more aggressive disease in a smaller lesion, highlighting the limitations of relying on size alone for the management of patients with sporadic multi-focal RCC. Download PPT Source of Funding: There is no source of funding © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e591 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Shavy Nagpal More articles by this author Dongling Wu More articles by this author Olivia Kola More articles by this author Jesse Pesily More articles by this author Sameer Thakker More articles by this author Fang Ming Deng More articles by this author Katie Murray More articles by this author William Huang More articles by this author Expand All Advertisement PDF downloadLoading ...