MP50-04 HYPERTENSION IS THE PRIMARY COMPONENT OF METABOLIC SYNDROME ASSOCIATED WITH RENAL TUMOR PATHOLOGY

Abstract

METHODS: A retrospective review of our institutional renal surgery database identified 541 patients who underwent partial or radical nephrectomy. Clinical, demographic, and pathologic data were collected. A linear fixed effects model analyzed the association of hybrid pathology with tumor size. Logistic regression determined the relationship of hybrid pathology with overall tumor stage and grade. RESULTS: 322 men and 219 women with a median BMI of 31 and median tumor size of 3.5 cm were included. 462 of these 541 patients (86%) had pathologic kidney cancer with the most common histologies being clear cell in 343 (74%), papillary in 81 (18%), and chromophobe in 25 (5%). Of the 462 kidney cancer specimens, 26 (5.6%) had hybrid tumors on final pathology. In these cases, clear cell RCC was the most common primary histology (n1⁄419) with papillary (n1⁄412) and sarcomatoid (n1⁄46) histologies being the most common secondary hybrid elements (Table). Hybrid kidney cancer was associated with an increased overall tumor grade (OR 2.6, 95% CI 1.16 e 5.85, p1⁄40.021). In particular, analysis of individual grades identified the highest association with Fuhrman grade 4 kidney cancer (OR 8.6, 95% CI 2.2 e 29.3, p1⁄40.001). Additionally, hybrid RCC was also associated with increasing pT3 tumor stage (OR 2.56, CI 95% 0.91e6.63, p1⁄40.05). CONCLUSIONS: This contemporary cohort of patients undergoing renal tumor surgery highlights a low incidence (w5%) of hybrid kidney cancer at final pathology. When hybrid elements are present, however, these tumors more likely demonstrate higher pathologic grade and stage. Larger studies are necessary to further define the effects of hybrid tumors on RCC outcomes and patient prognosis.