737 RENAL CELL CARCINOMA IN PATIENTS WITH END-STAGE RENAL DISEASE HAS FAVORABLE OVERALL PROGNOSIS

Abstract

You have accessJournal of UrologyKidney Cancer: Evaluation & Staging (II)1 Apr 2013737 RENAL CELL CARCINOMA IN PATIENTS WITH END-STAGE RENAL DISEASE HAS FAVORABLE OVERALL PROGNOSIS Adam Shrewsberry, Adeboye Osunkoya, Kun Jiang, Ruth Westby, Daniel Canter, John Pattaras, Nicole Turgeon, Viraj Master, and Kenneth Ogan Adam ShrewsberryAdam Shrewsberry Atlanta, GA More articles by this author , Adeboye OsunkoyaAdeboye Osunkoya Atlanta, GA More articles by this author , Kun JiangKun Jiang Atlanta, GA More articles by this author , Ruth WestbyRuth Westby Atlanta, GA More articles by this author , Daniel CanterDaniel Canter Atlanta, GA More articles by this author , John PattarasJohn Pattaras Atlanta, GA More articles by this author , Nicole TurgeonNicole Turgeon Atlanta, GA More articles by this author , Viraj MasterViraj Master Atlanta, GA More articles by this author , and Kenneth OganKenneth Ogan Atlanta, GA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.300AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Patients with end-stage renal disease (ESRD) demonstrate a greater risk for renal cell carcinoma (RCC) than the general population. Typically, patients undergoing transplant evaluation that are found to have a renal tumor are treated with nephrectomy prior to transplantation. We hypothesize that the prognosis of these patients is better than patients without ESRD and thus can avoid delayed transplantation. METHODS A total of 126 patients with renal tumors and ESRD that underwent nephrectomy since 1999 at our institution were retrospectively reviewed. Of these patients, 85 were found to have RCC, making up our cohort. These patients' charts as well as the charts of 238 control patients without ESRD-associated RCC were reviewed to determine baseline characteristics, pathologic staging, and overall mortality. RESULTS The ESRD group was younger (56.1 vs. 59.8 years, p=0.02), but had a higher mean age-adjusted Charleston Comorbidity Index (4.7 vs. 2.7, p<0.001). Eleven of the ESRD patients versus 5 of the control patients had bilateral nephrectomies. Average time on dialysis was 4.45 +/- 4.72 years with 68% having radiographic evidence of acquired renal cystic disease (ARCD). Thirty-one percent of patients eventually underwent transplantation. In the ESRD patients, 90.6% had T1 or T2 disease compared with 73.3% in the control group (p<0.001). Kidneys in the control group were more likely to have clear cell RCC (73.3% vs. 36.5%, p<0.001) whereas kidneys in the ESRD group were more likely to have papillary RCC (38.5% vs. 16.0%, p<0.001). Fifty-three percent of patients with ESRD had Fuhrman grade 1 or 2 tumors compared to 47% in the control group (p=0.43). Average Karakiewicz nomogram score was 49.6 in the ESRD group versus 88.8 in the control group (p<0.001). At a mean follow-up of 1.8 years and 3.3 years for the ESRD and control groups, respectively, recurrence rates were 3.1% versus 16.8%, (p=0.004). There was no difference in overall mortality between the two groups (26% vs. 33%, p=0.25). CONCLUSIONS Patients with ESRD who develop RCC have a better prognosis compared to RCC in the general population. Thus, the standard delay between nephrectomy and renal transplantation may not be necessary. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e303 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Adam Shrewsberry Atlanta, GA More articles by this author Adeboye Osunkoya Atlanta, GA More articles by this author Kun Jiang Atlanta, GA More articles by this author Ruth Westby Atlanta, GA More articles by this author Daniel Canter Atlanta, GA More articles by this author John Pattaras Atlanta, GA More articles by this author Nicole Turgeon Atlanta, GA More articles by this author Viraj Master Atlanta, GA More articles by this author Kenneth Ogan Atlanta, GA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...