MP28-06 METASTATIC RISK STRATIFICATION OF CLEAR CELL RENAL CELL CARCINOMA PATIENTS BASED ON A GENOMIC SCORE

Abstract

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging I1 Apr 2018MP28-06 METASTATIC RISK STRATIFICATION OF CLEAR CELL RENAL CELL CARCINOMA PATIENTS BASED ON A GENOMIC SCORE Julia Grimm, MArtin Janssen, Stefan Wagenpfeil, Arndt Hartmann, Christine Stöhr, Bastian Keck, Andreas Kahlmeyer, Michael Stöckle, and Kerstin Junker Julia GrimmJulia Grimm More articles by this author , MArtin JanssenMArtin Janssen More articles by this author , Stefan WagenpfeilStefan Wagenpfeil More articles by this author , Arndt HartmannArndt Hartmann More articles by this author , Christine StöhrChristine Stöhr More articles by this author , Bastian KeckBastian Keck More articles by this author , Andreas KahlmeyerAndreas Kahlmeyer More articles by this author , Michael StöckleMichael Stöckle More articles by this author , and Kerstin JunkerKerstin Junker More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.906AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prognostic markers for the definition of the individual metastatic risk are still missing. Chromosomal copy number variations have the potential to be prognostic markers. Aim of this study was to establish a total number of specific aberrations score as a new prognostic test. METHODS FISH was performed on isolated cell nuclei of 100 ccRCCs (50 M1/50 M0) and 100 FFPE sections on TMAs from a 2nd cohort (32 M1/68 M0). For each chromosomal region (1q21.3, 7q36.3, 9p21.3p24.1 and 20q11.21q13.32) cut-off values were determined by ROC-curve analysis. TNSA was calculated based on the dichotomized specific CNVs. The prognostic significance of CNVs was proven by Cox and logistic regression. RESULTS TNSA was the best predictor of metastasis in both cohorts. We derived an algorithm for risk stratification by combining TNSA and T-category, which increased the prognostic accuracy to 87% (Specificity= 86%, Sensitivity= 88%) and 84% (Specificity=93%, Sensitivity= 66%) respectively. Both TNSA and T-category are independent prognostic factors of progression in cohort 1 and metastatic risk increases with each additional CNV by 3.7-fold. TNSA was an independent predictor of PFS in both cohorts. In organ confined tumors TNSA was the only significant indicator of progression. CONCLUSIONS We present a new, powerful tool for individual as well as whole cohort risk stratification by combining genetic alterations with clinico-pathologic parameters. TNSA was validated as an independent prognostic factor for ccRCC. Interphase FISH proves to be a dependable method for prognostic evaluation in primary tumor tissue on isolated cell nuclei as well as on FFPE sections. Especially in organ-confined tumors the genetic score seems to be an important tool to identify patients at high risk for metastatic disease. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e358 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Julia Grimm More articles by this author MArtin Janssen More articles by this author Stefan Wagenpfeil More articles by this author Arndt Hartmann More articles by this author Christine Stöhr More articles by this author Bastian Keck More articles by this author Andreas Kahlmeyer More articles by this author Michael Stöckle More articles by this author Kerstin Junker More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...