MP14-12 DISAGREEMENTS BETWEEN MEMORIAL SLOAN KETTERING CANCER CENTER (MSKCC) AND THE INTERNATIONAL METASTATIC RCC DATABASE CONSORTIUM (IMDC) PROGNOSTIC SCORE AND THEIR IMPACT ON SURVIVAL OUTCOMES IN CLEAR-CELL METASTATIC RENAL CELL CARCINOMA (mRCC) PATIENTS TREATED WITH TYROSINE-KINASE INHIBITORS (TKI)

Abstract

You have accessJournal of UrologyKidney Cancer: Advanced (including Drug Therapy) I (MP14)1 Sep 2021MP14-12 DISAGREEMENTS BETWEEN MEMORIAL SLOAN KETTERING CANCER CENTER (MSKCC) AND THE INTERNATIONAL METASTATIC RCC DATABASE CONSORTIUM (IMDC) PROGNOSTIC SCORE AND THEIR IMPACT ON SURVIVAL OUTCOMES IN CLEAR-CELL METASTATIC RENAL CELL CARCINOMA (mRCC) PATIENTS TREATED WITH TYROSINE-KINASE INHIBITORS (TKI) Florian Janisch, Phillip Marks, Philipp Gild, Christian P. Meyer, Constantin Fühner, Roland Dahlem, Shahrokh F. Shariat, Margit Fisch, and Michael Rink Florian JanischFlorian Janisch More articles by this author , Phillip MarksPhillip Marks More articles by this author , Philipp GildPhilipp Gild More articles by this author , Christian P. MeyerChristian P. Meyer More articles by this author , Constantin FühnerConstantin Fühner More articles by this author , Roland DahlemRoland Dahlem More articles by this author , Shahrokh F. ShariatShahrokh F. Shariat More articles by this author , Margit FischMargit Fisch More articles by this author , and Michael RinkMichael Rink More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001995.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Clear-cell histology is the most common histologic subtype in patients with metastatic renal cell carcinoma (mRCC) in the tyrosine-kinase era. Treatment strategies are dependent on proper risk stratification. Differential risk stratification between the Memorial Sloan Kettering Cancer Center (MSKCC) and the International Metastatic RCC Database Consortium (IMDC) prognostic score complicates clinical decision-making. We aimed to assess the specifics and impact of disagreement between IMDC and MSKCC risk scores on survival outcomes in patients with clear-cell mRCC (ccmRCC) treated with TKIs METHODS: 215 patients with ccmRCC treated with TKIs were analyzed. Calculation of MSKCC and IMDC was performed based on clinical data and patients were grouped according to disagreement between the scores. Cohen’s kappa was used to assess overall agreement between the risk scores. We used descriptive analysis to assess differences between the two groups as well as Kaplan-Meier estimates to assess the association of disagreement on overall (OS) and progression-free survival (PFS) as primary co-endpoints. RESULTS: Overall, 169 (78.6%) of patients were in agreement between risk scores, with a Cohen’s kappa of 0.624 (p<0.01). 8 patients (22.4%) were upgraded to higher, and 38 patients (77.6%) were downgraded to a lower risk group from MSKCC to IMDC score. Neutrophil leucocyte serum levels were the most frequent score-relevant factors involved in upgrading in 7 patients (87.5%) and LDH serum levels were the most frequent reason for downgrading in 38 patients (100%), respectively. Patients with agreement in prognostic risk scores had significantly worse IMDC score groups (p<0.01), more frequently time to systematic therapy <1 year (p=0.03), and had more frequently a LDH ≤1.5 fold of the upper normal level (p≤0.01). There was no association between agreement of the scores and OS (HR: 0.94; 95%-CI=0.64-1.38; p=0.7) or PFS (HR: 1.20; 95%-CI=0.80-1.79; p=0.4) in univariable analyses. CONCLUSIONS: There was a moderate agreement between IMDC and MSKCC score groups ccmRCC patients treated with TKI. OS and PFS were not impacted by disagreement between the score. Despite the preferred role of the IMDC for risk stratification, results of studies using the MSKCC score can be used for comparison of results in research and the clinical setting. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e257-e258 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Florian Janisch More articles by this author Phillip Marks More articles by this author Philipp Gild More articles by this author Christian P. Meyer More articles by this author Constantin Fühner More articles by this author Roland Dahlem More articles by this author Shahrokh F. Shariat More articles by this author Margit Fisch More articles by this author Michael Rink More articles by this author Expand All Advertisement Loading ...