Mp51-14 Is Pathological Upstaging to T3a Renal Cell Carcinoma Associated With a Similar Prognosis to Non-Upstaged Pathologic T3a Disease? A Multicenter Analysis

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging/Surveillance II (MP51)1 May 2024MP51-14 IS PATHOLOGICAL UPSTAGING TO T3A RENAL CELL CARCINOMA ASSOCIATED WITH A SIMILAR PROGNOSIS TO NON-UPSTAGED PATHOLOGIC T3A DISEASE? A MULTICENTER ANALYSIS Jonathan Afari, Ryan Nasseri, Umberto Capitanio, Cesare Saitta, Riccardo Autorino, Brian R. Lane, Hajime Tanaka, Kevin Hakimi, Ava Saidian, Michele Marchioni, Dattatraya Patil, Mimi V. Nguyen, Dhruv Puri, Jacob Roberts, Margaret Meagher, Kit Yuen, Sabrina L. Noyes, Chandru Sundaram, Francesco Porpiglia, James R. Porter, Viraj Master, Andrea Minervini, Yasuhisa Fujii, Francesco Montorsi, and Ithaar Derweesh Jonathan AfariJonathan Afari , Ryan NasseriRyan Nasseri , Umberto CapitanioUmberto Capitanio , Cesare SaittaCesare Saitta , Riccardo AutorinoRiccardo Autorino , Brian R. LaneBrian R. Lane , Hajime TanakaHajime Tanaka , Kevin HakimiKevin Hakimi , Ava SaidianAva Saidian , Michele MarchioniMichele Marchioni , Dattatraya PatilDattatraya Patil , Mimi V. NguyenMimi V. Nguyen , Dhruv PuriDhruv Puri , Jacob RobertsJacob Roberts , Margaret MeagherMargaret Meagher , Kit YuenKit Yuen , Sabrina L. NoyesSabrina L. Noyes , Chandru SundaramChandru Sundaram , Francesco PorpigliaFrancesco Porpiglia , James R. PorterJames R. Porter , Viraj MasterViraj Master , Andrea MinerviniAndrea Minervini , Yasuhisa FujiiYasuhisa Fujii , Francesco MontorsiFrancesco Montorsi , and Ithaar DerweeshIthaar Derweesh View All Author Informationhttps://doi.org/10.1097/01.JU.0001009492.49624.4b.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We compared survival outcomes and predictors in patients with upstaged T3a Renal Cell Carcinoma (RCC) versus non-upstaged pT3a RCC, as comparison of pathologically-upstaged T3a RCC and T3a RCC which was not upstaged has not been performed. METHODS: We conducted a multicenter retrospective analysis. Patients were classified as cT1/cT2 RCC upstaged (pT3a-US) or non-upstaged (cT3a/pT3a-NUS). Primary outcome was All-Cause Mortality (ACM). Secondary outcomes were Cancer-Specific Mortality (CSM), and Recurrence. Multivariable Cox regression analysis (MVA) were conducted for outcomes. Kaplan-Meier Analyses (KMA) were conducted to compare Overall (OS), Cancer-Specific (CSS), and Recurrence-Free Survival (RFS), in pT3a-US and pT3a-NUS. RESULTS: We analyzed 879 patients [pT3a-US 69; pT3a-NUS 188; median follow-up 48 months]. MVA for ACM demonstrated increasing tumor size (HR 1.07, p=0.022), high-grade (HR 2.74, p<0.001) as independent risk factors. MVA for CSM demonstrated increasing tumor size (HR 1.11, p=0.005), high-grade (HR 2.36, p=0.003), and positive margin (HR 5.58, p=0.007) as independent predictors. MVA for recurrence revealed increasing tumor size (HR 1.05, p=0.05), high-grade (HR 3.55, p<0.001), and positive margin (HR 3.44, p<0.001) as independent predictors. pT3a-US was not an independent predictor in ACM (p=0.204), CSM (p=0.711), or recurrence (p=0.934). Comparing pT3a-NUS vs. pT3a-US, KMA revealed no difference in 5-year OS (60% vs. 62%, p=0.378), and worsened 5-year CSS and RFS were worse for pT3a-NUS (51% vs. 61%, p=0.04; 42% vs. 63%, p<0.001; Figure 1). CONCLUSIONS: Pathological upstaging is not an independent predictor of survival outcomes. In T3a RCC increasing tumor size and high-grade or presence of positive margin are main drivers of survival outcomes. Download PPT Source of Funding: Weissman Kidney Cancer Institute © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e847 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Jonathan Afari More articles by this author Ryan Nasseri More articles by this author Umberto Capitanio More articles by this author Cesare Saitta More articles by this author Riccardo Autorino More articles by this author Brian R. Lane More articles by this author Hajime Tanaka More articles by this author Kevin Hakimi More articles by this author Ava Saidian More articles by this author Michele Marchioni More articles by this author Dattatraya Patil More articles by this author Mimi V. Nguyen More articles by this author Dhruv Puri More articles by this author Jacob Roberts More articles by this author Margaret Meagher More articles by this author Kit Yuen More articles by this author Sabrina L. Noyes More articles by this author Chandru Sundaram More articles by this author Francesco Porpiglia More articles by this author James R. Porter More articles by this author Viraj Master More articles by this author Andrea Minervini More articles by this author Yasuhisa Fujii More articles by this author Francesco Montorsi More articles by this author Ithaar Derweesh More articles by this author Expand All Advertisement PDF downloadLoading ...