MP59-11 CYSTIC RENAL CELL CARCINOMA PORTENDS EXCELLENT PROGNOSIS – RESULTS OF A LARGE POPULATION-LEVEL OUTCOME STUDY

Abstract

You have accessJournal of UrologyKidney Cancer: Localized IV1 Apr 2014MP59-11 CYSTIC RENAL CELL CARCINOMA PORTENDS EXCELLENT PROGNOSIS – RESULTS OF A LARGE POPULATION-LEVEL OUTCOME STUDY Jaimin R. Bhatt, Sarah Kawaguchi, Patrick O. Richard, Shabbir Alibhai, Narhari Timilshina, Michael Jewett, and Antonio Finelli Jaimin R. BhattJaimin R. Bhatt More articles by this author , Sarah KawaguchiSarah Kawaguchi More articles by this author , Patrick O. RichardPatrick O. Richard More articles by this author , Shabbir AlibhaiShabbir Alibhai More articles by this author , Narhari TimilshinaNarhari Timilshina More articles by this author , Michael JewettMichael Jewett More articles by this author , and Antonio FinelliAntonio Finelli More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1807AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Renal cell carcinoma (RCC) makes up 3-5% of all cancers. Of these, cystic RCCs constitute between 3-14%, and are often detected incidentally as complex enhancing renal cysts on imaging. Since 2004, there has been a pathological reclassification of cystic clear RCC leading to description of multilocular cystic RCC (mcRCC) as a subtype of clear cell RCC. Other types include tubulocystic RCC. We aimed to study the histologic patterns and survival outcomes of all recorded cystic RCCs using a province-wide cancer registry database for Ontario. Methods A retrospective review of all histologically-proven cases of cystic RCC treated by partial or radical nephrectomy (PN or RN) between 1995 and 2004 identified from the Ontario Cancer Registry was performed. Patient demographics, type of surgery, histologic features and survival outcomes were evaluated. Results A total of 107 cystic RCCs were identified in 106 patients. Mean age was 55 years, with a male preponderance of 58%. RN was performed in 55% with adrenalectomy in 25%. Mean lesion size at histology was 4.16cm(1-18cm). Vast majority (106) were cystic clear-cell or multilocular cystic RCC (mcRCC) with one case of tubulocystic RCC. Ninety-five % were low grade (Fuhrman grade 1-2). There was only 1 case of vascular invasion and none of lymphatic invasion. None of the cases involved the renal pelvis or adrenal gland where removed. There were 2 small renal vein thrombi, and 3 cases of perinephric fat invasion. All cases were margin-negative. Patients had a median post-operative follow up of 5 years. Twelve deaths were reported but none were caused by RCC. Conclusions We believe that our study is the largest series of cystic RCCs to date. It confirms a favourable histology and an excellent prognosis of mcRCC. Given that this series excludes patients who underwent surgery and had a final pathological diagnosis which was benign, the magnitude of this favourable prognosis is under-represented. This makes a strong case for nephron-sparing, adrenal-saving approach for cystic renal masses suspicious of being RCCs. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e654 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Jaimin R. Bhatt More articles by this author Sarah Kawaguchi More articles by this author Patrick O. Richard More articles by this author Shabbir Alibhai More articles by this author Narhari Timilshina More articles by this author Michael Jewett More articles by this author Antonio Finelli More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...