MP30-19 LYMPHOPENIA IS AN INDEPENDENT PREDICTOR OF INFERIOR SURVIVAL IN PAPILLARY RENAL CELL CARCINOMA.

Abstract

You have accessJournal of UrologyKidney Cancer: Evaluation/Staging II1 Apr 2014MP30-19 LYMPHOPENIA IS AN INDEPENDENT PREDICTOR OF INFERIOR SURVIVAL IN PAPILLARY RENAL CELL CARCINOMA. Reza Mehrazin, Robert G. Uzzo, Alexander Kutikov, Karen Ruth, Jeffrey J. Tomaszewski, Serge Ginzberg, Daniel Canter, Essel Dulaimi, Philip Abbosh, Timothy Ito, David Y.T. Chen, Richard E. Greenberg, Rosalia Viterbo, and Tahseen Al-Saleem Reza MehrazinReza Mehrazin More articles by this author , Robert G. UzzoRobert G. Uzzo More articles by this author , Alexander KutikovAlexander Kutikov More articles by this author , Karen RuthKaren Ruth More articles by this author , Jeffrey J. TomaszewskiJeffrey J. Tomaszewski More articles by this author , Serge GinzbergSerge Ginzberg More articles by this author , Daniel CanterDaniel Canter More articles by this author , Essel DulaimiEssel Dulaimi More articles by this author , Philip AbboshPhilip Abbosh More articles by this author , Timothy ItoTimothy Ito More articles by this author , David Y.T. ChenDavid Y.T. Chen More articles by this author , Richard E. GreenbergRichard E. Greenberg More articles by this author , Rosalia ViterboRosalia Viterbo More articles by this author , and Tahseen Al-SaleemTahseen Al-Saleem More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.827AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Lymphopenia signifies inflammatory response and is an index of poor systemic immunity which can be associated with poor survival outcomes. The aim of this study was to evaluate the prognostic relevance of preoperative absolute lymphocyte count (ALC) in patients with papillary renal cell carcinoma (RCC). METHODS We retrospectively analyzed our institutional, prospectively maintained, renal cancer database and identified patients with pathologic diagnosis of papillary RCC after partial or radical nephrectomy. Patients with preoperative ALC value within 3 months prior to surgery were eligible for the study. ALC of 1,300 cells/μl was used as the cutoff value (our lowest laboratory reference value). We evaluated the correlation between ALC and age, gender, Charlson comorbidity index (CCI), smoking history, pathologic T stage, nuclear grade, and overall TNM stage with linear regression or trend tests. Differences in overall survival (OS) by ALC status were assessed using the log−rank test. Cox proportional hazards modeling was used for multivariable analyses. RESULTS We identified 293 out of 2,732 patients with a pathologic diagnosis of papillary RCC after partial or radical nephrectomy from 1997 to 2013. Those undergoing multiple surgical procedures (multifocal or bilateral disease) or missing preoperative ALC were excluded from the study. A total 192 patients met inclusion criteria with a median follow up of 37.3 months. As a continuous variable, low absolute lymphocyte count was associated with higher pT stage (p=0.001), TNM stage (p=0.001) and older age (p=0.012). Lymphopenia below 1,300 cells/μl was also associated with pT stage (p<0.001) and TNM stage (p=0.003). On multivariable analysis, independent of stage, age, CCI, and history of smoking, lymphopenia was associated with inferior overall survival (HR 2.15 [CI 1.08-4.29], p=0.030). CONCLUSIONS In our series of patients with papillary renal cell carcinoma, lymphopenia was associated with lower overall survival independent of stage, age, history of smoking, and Charlson comorbidity index. ALC appears to be an independent prognostic factor for overall survival in papillary RCC patients, and can be helpful for preoperative patient counseling, tailoring individual patient surveillance schedule, and designing clinical trials. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e321-e322 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Reza Mehrazin More articles by this author Robert G. Uzzo More articles by this author Alexander Kutikov More articles by this author Karen Ruth More articles by this author Jeffrey J. Tomaszewski More articles by this author Serge Ginzberg More articles by this author Daniel Canter More articles by this author Essel Dulaimi More articles by this author Philip Abbosh More articles by this author Timothy Ito More articles by this author David Y.T. Chen More articles by this author Richard E. Greenberg More articles by this author Rosalia Viterbo More articles by this author Tahseen Al-Saleem More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...