Pd11-06 Histologic Concordance and Metastatic Disease in Bilateral Renal Cell Carcinoma

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy I (PD11)1 May 2024PD11-06 HISTOLOGIC CONCORDANCE AND METASTATIC DISEASE IN BILATERAL RENAL CELL CARCINOMA Kieran Lewis, Eran Maina, Jason Scovell, Carlos Munoz-Lopez, and Steven C. Campbell Kieran LewisKieran Lewis , Eran MainaEran Maina , Jason ScovellJason Scovell , Carlos Munoz-LopezCarlos Munoz-Lopez , and Steven C. CampbellSteven C. Campbell View All Author Informationhttps://doi.org/10.1097/01.JU.0001008604.95535.b9.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Bilateral RCC (bRCC) represents a unique scenario where tumors most often represent two independent tumor origins, although hematogenous metastasis to the contralateral kidney can also occur. As such, some patients with concordant histology (e.g. clear cell/clear cell) may be at increased risk for systemic metastases. At present, there is no way to distinguish these two mechanisms in clinical practice. Our objective was to evaluate the association between histologic concordance in bRCC and systemic metastasis. METHODS: Of 447 patients treated for bilateral renal masses between 2002-2022, 359 non-familial patients with available bilateral pathology and malignancy on at least one side were analyzed. Long-term follow-up regarding progression to systemic metastasis was collected, and Kaplan Meier was performed to compare the concordant/discordant cohorts. The most advanced tumor was considered the index tumor. RESULTS: Of 359 patients, 238 (66%) had histologic concordance. Three patients (1%) presented initially with metastatic disease and 35 (10%) developed metastasis (Table 1). Tumor stage, grade, size, and contralateral multifocality (3+ tumors) all associated with the development of metastatic disease (Table 1, all p<0.05). Clear cell concordant histology progressed to metastasis more frequently than clear cell discordant histology (18% vs 8%, Table 1, p<0.01). Metastasis-free survival was reduced in those with concordant histology across all subtypes (Figure 1, p<0.05). CONCLUSIONS: Our findings suggest that bRCC patients with concordant histology are at higher risk of systemic metastasis, particularly those with bilateral clear cell histology. The increased risk seen in this cohort may be because there are two sites for potential spread, although some proportion of histologically concordant bRCC likely represents metastatic disease to the contralateral kidney. Contralateral multifocality may also help identify these patients, possibly because hematogenous spread to the kidney often seeds multiple sites. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e251 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Kieran Lewis More articles by this author Eran Maina More articles by this author Jason Scovell More articles by this author Carlos Munoz-Lopez More articles by this author Steven C. Campbell More articles by this author Expand All Advertisement PDF downloadLoading ...