MP28-20 KIDNEY CANCER WELLNESS DETERMINANT (KCWD) AN ADJUNCTIVE TOOL TO PREDICT SURVIVAL IN RENAL CELL CARCINOMA

Abstract

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging I1 Apr 2018MP28-20 KIDNEY CANCER WELLNESS DETERMINANT (KCWD) AN ADJUNCTIVE TOOL TO PREDICT SURVIVAL IN RENAL CELL CARCINOMA Ahmet Bindayi, Aaron Bloch, Zachary Hamilton, Shreyas Joshi, Madhumitha Reddy, Stephen Ryan, Ryan Nasseri, Robert Uzzo, and Ithaar Derweesh Ahmet BindayiAhmet Bindayi More articles by this author , Aaron BlochAaron Bloch More articles by this author , Zachary HamiltonZachary Hamilton More articles by this author , Shreyas JoshiShreyas Joshi More articles by this author , Madhumitha ReddyMadhumitha Reddy More articles by this author , Stephen RyanStephen Ryan More articles by this author , Ryan NasseriRyan Nasseri More articles by this author , Robert UzzoRobert Uzzo More articles by this author , and Ithaar DerweeshIthaar Derweesh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.920AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Renal Cell Carcinoma (RCC) is a metabolically driven neoplasm. Inflammatory markers and morphometric measures have been suggested to be predictive for prognosis. We investigated the impact of a novel combination of preoperative tumor morphology (RENAL score) and a laboratory based inflammatory marker (DeRitis Ratio, AST/ALT) on survival outcomes in patients with RCC. METHODS Two-center, retrospective analysis of patients who underwent treatment for RCC. A prognostic index was created (kidney cancer wellness determinant-KCWD) through a composite index of increasing positive markers (″Score of 0″=RENAL ≤8 and DeRitis ≤1.5, ″Score of 1″=RENAL >8 or DeRitis >1.5, ″Score of 2″=RENAL >8 and DeRitis>1.5), and analyzed within different AJCC Stage Groups (I,II,III,IV). Primary outcome was overall survival (OS). Logistic regression analysis and Kaplan Meier survival (KMS) plots for overall survival (OS) were utilized. RESULTS 1674 patients were analyzed (mean age 61.9 years, 63.5% underwent PN, 35.3% underwent RN, and 1.2% underwent thermal ablation). Overall, 758 (45.3%), 861 (51.4%) and 55(3.3%) of them had index score of 0, 1 and 2, respectively. KMS analysis showed 89.5% 5-year estimated OS for index score of 0, 72.2% for 1 and 44% for 2 (p<0.001). Multivariate analysis for OS revealed that increasing age (HR 1.114, p <0.001), tumor size (HR 1.148, p<0.001), and increasing KCWD score (reference 0) of 1 (HR 2.753, p=0.024), and 2 (HR 3.929, p=0.005) as risk factors for mortality. KMA KCWD score by stage showed significant OS difference in patients with stage I (p <0.001) and stage III (p = 0.006) disease. (Table) CONCLUSIONS KCWD represents a novel combination of a morphological score (RENAL) and an inflammatory marker (DeRitis ratio) which functions as an independent predictor of survival outcomes in RCC and may add further discernment to outcomes within different staging categories. Further investigation is requisite. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e364 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Ahmet Bindayi More articles by this author Aaron Bloch More articles by this author Zachary Hamilton More articles by this author Shreyas Joshi More articles by this author Madhumitha Reddy More articles by this author Stephen Ryan More articles by this author Ryan Nasseri More articles by this author Robert Uzzo More articles by this author Ithaar Derweesh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...