MP36-14 CAN HEMATURIA BE USED TO PREDICT RCC VS. ONCOCYTOMA HISTOLOGY?

Abstract

You have accessJournal of UrologyKidney Cancer: Evalution/Staging III1 Apr 2014MP36-14 CAN HEMATURIA BE USED TO PREDICT RCC VS. ONCOCYTOMA HISTOLOGY? Michael Hanzly, Terry Creighton, Christine Murekeyisoni, Elizabeth Devine, Shervin Badkhshan, Michael Mungillo, Thomas Schwaab, and Eric Kauffman Michael HanzlyMichael Hanzly More articles by this author , Terry CreightonTerry Creighton More articles by this author , Christine MurekeyisoniChristine Murekeyisoni More articles by this author , Elizabeth DevineElizabeth Devine More articles by this author , Shervin BadkhshanShervin Badkhshan More articles by this author , Michael MungilloMichael Mungillo More articles by this author , Thomas SchwaabThomas Schwaab More articles by this author , and Eric KauffmanEric Kauffman More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1078AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Hematuria is a classic presenting sign of renal cell carcinoma (RCC), however its incidence in individual RCC histologic subtypes and the benign renal cell tumor, oncocytoma, has not been characterized. We investigated whether hematuria at presentation can be used to help predict benign versus malignant histology of renal cell tumors. METHODS We identified all renal cell tumor patients undergoing partial or radical nephrectomy at a single National Comprehensive Cancer Network (NCCN)-designated cancer center since 2004 with preoperative urine testing, including urine dipstick and/or microscopic uranalysis. Patients with unclassified RCC or mixed histologies were excluded. Incidence of preoperative microscopic or gross hematuria was determined and statistically compared among different renal tumor histologic subtypes, including after stratification by tumor size. RESULTS A total of 292 patients met criteria, including 211 clear cell (72%), 42 papillary (14%), 25 oncocytoma (9%) and 14 chromophobe (5%). Overall incidence of hematuria was 40%, including 12% gross and 28% microscopic only. Hematuria did not correlate with tumor size, but was significantly associated with benign versus malignant tumor histology. Specifically, oncocytoma patients had only a 16% incidence of hematuria compared to >40% incidence for each of the common RCC histologic subtypes (all RCC= 43%, p<0.01). (Table) Cases of isolated hematuria without pyuria were similarly less common in oncocytoma patients (4%) compared to RCC subtypes (25-36% each; all RCC= 25%, p<0.01). When analyzing pT1a tumors alone, oncocytoma patients again had just a 5% incidence of hematuria compared to 25-36% for individual RCC subtypes (all RCC= 35%, p<0.01), and a similar significant distinction between oncocytoma (5%) and RCC (25%, p<0.05) was again observed when only hematuria cases without pyuria were analyzed. CONCLUSIONS This is the first study to our knowledge characterizing hematuria in renal oncocytoma and different RCC histologic subtypes. Our findings support hematuria as a clinical marker for renal tumor malignant potential, occurring frequently in RCC but uncommonly in oncocytoma. Urine testing for blood may aid in risk stratification of small renal mass patients being considered for active surveillance in the absence of histologic diagnosis. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e384 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Michael Hanzly More articles by this author Terry Creighton More articles by this author Christine Murekeyisoni More articles by this author Elizabeth Devine More articles by this author Shervin Badkhshan More articles by this author Michael Mungillo More articles by this author Thomas Schwaab More articles by this author Eric Kauffman More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...