MP14-07 NORMALIZATION OF PRE-OPERATIVE LABS AFTER CYTOREDUCTIVE NEPHRECTOMY IS ASSOCIATED WITH IMPROVED SURVIVAL

Abstract

You have accessJournal of UrologyKidney Cancer: Advanced (including Drug Therapy) I (MP14)1 Sep 2021MP14-07 NORMALIZATION OF PRE-OPERATIVE LABS AFTER CYTOREDUCTIVE NEPHRECTOMY IS ASSOCIATED WITH IMPROVED SURVIVAL Ashanda Esdaille, Viraj Master, Philippe Spiess, Jay Raman, Andrew Watts, Wade Sexton, Logan Zemp, Alyssa Bilotta, Dattatraya Patil, Glenn Allen, Daniel Shapiro, Surena Matin, Jose Karam, Christopher Wood, and E. Jason Abel Ashanda EsdailleAshanda Esdaille More articles by this author , Viraj MasterViraj Master More articles by this author , Philippe SpiessPhilippe Spiess More articles by this author , Jay RamanJay Raman More articles by this author , Andrew WattsAndrew Watts More articles by this author , Wade SextonWade Sexton More articles by this author , Logan ZempLogan Zemp More articles by this author , Alyssa BilottaAlyssa Bilotta More articles by this author , Dattatraya PatilDattatraya Patil More articles by this author , Glenn AllenGlenn Allen More articles by this author , Daniel ShapiroDaniel Shapiro More articles by this author , Surena MatinSurena Matin More articles by this author , Jose KaramJose Karam More articles by this author , Christopher WoodChristopher Wood More articles by this author , and E. Jason AbelE. Jason Abel More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001995.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Multiple serum labs are used as prognostic factors for overall survival in metastatic renal cell carcinoma (mRCC). However, few studies investigate outcomes for patients with abnormal preoperative labs that return to normal (RTN) following cytoreductive nephrectomy (CN). The objective of this study is to evaluate the incidence and prognostic value of abnormal preoperative labs that return to normal following upfront cytoreductive nephrectomy. METHODS: Labs before and 4-6 weeks following CN were analyzed for mRCC patients treated at 5 centers 2006-2017, excluding patients with pre-surgical systemic therapy. Labs were considered abnormal if serum hemoglobin < lower limit normal (LLN), albumin < LLN, calcium > upper limit normal (ULN), platelets >ULN and absolute neutrophil count (ANC) > ULN. RTN defined as abnormal range labs which returned to normal following CN. Cox analysis evaluated associations of OS with RTN. RESULTS: A total of 914/1163 mRCC patients were treated with CN without pre-surgical systemic therapy. Both pre and post-operative values were available for 62-87% of labs measured. Median follow up for patients alive at last follow-up was 42.6 months (IQR 23-68). Preoperatively, abnormal lab values were present for hemoglobin 620/905 (68%), calcium 116/874 (13%), albumin 212/787 (27%), platelets 178/905 (20%) and ANC 100/647 (15%). For patients with abnormal preoperative labs, RTN postoperatively was identified in hemoglobin 18%, calcium 73%, albumin 53%, platelets 59%, and ANC 69%. Compared with abnormal pre and postoperative lab values, RTN was associated with significantly improved OS for hemoglobin HR 0.59 (95% CI 0.45-0.78, p<0.001), albumin HR 0.47 (95% CI 0.33-0.68, p<0.001), platelets HR 0.68 (95% CI 0.48-0.99, p=0.048), and ANC HR 0.43 (95% CI 0.26-0.70, p=0.001). OS for patients with preoperative abnormal labs (hemoglobin, albumin, platelets or ANC) that RTN had similar OS as patients with normal preoperative labs, and worse for patients with abnormal pre/post CN labs, p<0.0001 for each analysis. (figure shows hemoglobin vs OS) CONCLUSIONS: Abnormal lab values frequently (18-73%) return to normal values after cytoreductive nephrectomy. Return to normal values is associated with better overall survival and change in prognostic scores. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e254-e255 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ashanda Esdaille More articles by this author Viraj Master More articles by this author Philippe Spiess More articles by this author Jay Raman More articles by this author Andrew Watts More articles by this author Wade Sexton More articles by this author Logan Zemp More articles by this author Alyssa Bilotta More articles by this author Dattatraya Patil More articles by this author Glenn Allen More articles by this author Daniel Shapiro More articles by this author Surena Matin More articles by this author Jose Karam More articles by this author Christopher Wood More articles by this author E. Jason Abel More articles by this author Expand All Advertisement Loading ...