MP42-15 SURVIVAL OUTCOMES IN PATIENTS UNDERGOING PARTIAL COMPARED TO RADICAL NEPHRECTOMY FOR EARLY-STAGE RENAL CELL CARCINOMA WITH SARCOMATOID FEATURES

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy III (MP42)1 Sep 2021MP42-15 SURVIVAL OUTCOMES IN PATIENTS UNDERGOING PARTIAL COMPARED TO RADICAL NEPHRECTOMY FOR EARLY-STAGE RENAL CELL CARCINOMA WITH SARCOMATOID FEATURES Mohammad Mahmoud, Sean Kern, Fouad Harkal, Hristos Kaimakliotis, Timothy Masterson, Clint Cary, Arieh Shalhav, and Ronald Boris Mohammad MahmoudMohammad Mahmoud More articles by this author , Sean KernSean Kern More articles by this author , Fouad HarkalFouad Harkal More articles by this author , Hristos KaimakliotisHristos Kaimakliotis More articles by this author , Timothy MastersonTimothy Masterson More articles by this author , Clint CaryClint Cary More articles by this author , Arieh ShalhavArieh Shalhav More articles by this author , and Ronald BorisRonald Boris More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002063.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Small percentage of tumors with renal cell carcinoma (RCC) displays sarcomatoid features (SF). Outcomes are stage dependent with lower survival compared to RCC tumors without SF. We sought to evaluate the survival outcomes of partial nephrectomy (PN) compared to radical nephrectomy (RN) for early T1 N0 M0 renal cell carcinomas with SF. METHODS: The National Cancer Database from 2004 to 2014 was quired for T1a or T1b RCC with SF who underwent PN or RN. The Kaplan-Meier method and Log-rank test evaluated the impact of surgical approach, histology, and grade on overall survival (OS). RESULTS: Overall, 369 patients with three predominant histological subtypes met our inclusion criteria: Sarcomatoid RCC (SRCC) (125 patients, 36% had PN), clear cell RCC (CCRCC) with SF (182 patients, 35.7 % had PN), and RCC none-otherwise specified (NOSRCC) with SF (62 patients, 37.1% had PN). The OS was higher after PN over RN (60.47 vs 56.57 months, p=0.03, Figure 1). Positive margins (+m) were seen in 13 patients (3.52%) of which 12 occurred after PN (92.31%). Higher grade was associated with worse OS in SRCC (HR=3.65, p=0.003) and in CCRCC with SF (HR=2.51, p=0.004). In multivariate analysis, there were no statistically significant OS differences between PN and RN within each index histology. CONCLUSIONS: Partial nephrectomy is an acceptable option for Stage I RCC with sarcomatoid features despite higher rates of positive margins compared to radical nephrectomy. Because of the inherent invasiveness of sarcomatoid histology, higher grade translates to worse survival outcomes. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e777-e778 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mohammad Mahmoud More articles by this author Sean Kern More articles by this author Fouad Harkal More articles by this author Hristos Kaimakliotis More articles by this author Timothy Masterson More articles by this author Clint Cary More articles by this author Arieh Shalhav More articles by this author Ronald Boris More articles by this author Expand All Advertisement PDF DownloadLoading ...