MP45-05 IMPACT OF ELEVATED C-REACTIVE PROTEIN ON SURVIVAL OUTCOMES IN SMALL RENAL MASSES: ANALYSIS OF THE INMARC REGISTRY

Abstract

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging/Surveillance I (MP45)1 Sep 2021MP45-05 IMPACT OF ELEVATED C-REACTIVE PROTEIN ON SURVIVAL OUTCOMES IN SMALL RENAL MASSES: ANALYSIS OF THE INMARC REGISTRY Margaret Meagher, Dattatraya Patil, Kazutaka Saito, Devin Patel, Juan Javier-Desloges, Fady Ghali, Kevin Hakimi, Shady Soliman, Julia Yuan, Fang Wan, Yasuhisa Fujii, Viraj Master, and Ithaar Derweesh Margaret MeagherMargaret Meagher More articles by this author , Dattatraya PatilDattatraya Patil More articles by this author , Kazutaka SaitoKazutaka Saito More articles by this author , Devin PatelDevin Patel More articles by this author , Juan Javier-DeslogesJuan Javier-Desloges More articles by this author , Fady GhaliFady Ghali More articles by this author , Kevin HakimiKevin Hakimi More articles by this author , Shady SolimanShady Soliman More articles by this author , Julia YuanJulia Yuan More articles by this author , Fang WanFang Wan More articles by this author , Yasuhisa FujiiYasuhisa Fujii More articles by this author , Viraj MasterViraj Master More articles by this author , and Ithaar DerweeshIthaar Derweesh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002066.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Management of small renal masses (SRM) represents a therapeutic quandary given the low oncologic risk of most tumors and increasing incidental detection. We investigated the impact of elevated C-reactive protein (CRP) on survival outcomes and competing sources of mortality in a cohort of patients with renal cell carcinoma (RCC) and clinical tumor size ≤3 cm. METHODS: Multi-institutional retrospective analysis the International Marker Consortium for Renal Cancer (INMARC) of patients with SRM (clinical tumor size ≤3cm) managed by surgery. The cohort was divided into elevated CRP (≥0.5 ng/dL) vs. non-elevated CRP (<0.5 0.5 ng/dL) for descriptive analyses. Primary outcome was non-cancer mortality (NCM). Secondary outcomes included All Cause Mortality (ACM) and progression. Cox-regression analysis was used to elucidate predictive factors for NCM, ACM, and progression. Kaplan Meier Analysis (KMA) was performed to analyze 5 year Overall Survival (OS), Non-Cancer Survival (NCS), Cancer-Specific Survival (CSS), and Progression-Free Survival (PFS). RESULTS: 1014 patients were analyzed (586 non-elevated CRP, 428 elevated CRP). Elevated CRP patients were younger (57.0 vs. 59.5 years, p=0.001) with more diabetes (28.5% vs. 10.4%, p<0.001). Cox-regression revealed increasing age (HR=1.1, p=0.001) and elevated CRP (HR=10.2, <0.001) as independent risk factors for ACM. Increasing age (HR=1.04, p=0.001) and elevated CRP (HR=10.3, p<0.001) were also independently associated with worsened NCM, while high tumor grade (HR=2.4, p=0.012) but not elevated CRP (p=0.275) was an independent risk factor for progression. For elevated CRP, KMA revealed 5 year OS, NCS and CSS of 83%, 86%, and 95%, respectively. For non elevated CRP, KMA revealed 5 year OS, NCS and CSS of 98%, 98%, and 100%. CONCLUSIONS: Elevated CRP was an independent predictor of ACM and NCM, but not progression in patients with SRM. Patients with elevated CRP had lower OS and NCS compared to CSS. In such patients, oncologic risk stratification through biopsy should be considered prior to offering treatment and indolent or low-grade neoplasms should be strongly considered for non-surgical management. Patients with non elevated CRP had similar OS, NCS and CSS, and as such, primary surgical intervention may be considered from a more favorable risk benefit standpoint. Further investigation is requisite. Source of Funding: Stephen Weissman Kidney Cancer Research Fund © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e804-e804 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Margaret Meagher More articles by this author Dattatraya Patil More articles by this author Kazutaka Saito More articles by this author Devin Patel More articles by this author Juan Javier-Desloges More articles by this author Fady Ghali More articles by this author Kevin Hakimi More articles by this author Shady Soliman More articles by this author Julia Yuan More articles by this author Fang Wan More articles by this author Yasuhisa Fujii More articles by this author Viraj Master More articles by this author Ithaar Derweesh More articles by this author Expand All Advertisement Loading ...