MP61-08 TOWARDS PERSONALIZED CARE OF CT1A PAPILLARY RCC DIAGNOSED ON BIOPSY

Abstract

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging/Surveillance III (MP61)1 Sep 2021MP61-08 TOWARDS PERSONALIZED CARE OF CT1A PAPILLARY RCC DIAGNOSED ON BIOPSY Johan Björklund, Douglas C Cheung, Robert J Hamilton, John Kachura, Michael Jewett, Alexandre R Zlotta, and Antonio Finelli Johan BjörklundJohan Björklund More articles by this author , Douglas C CheungDouglas C Cheung More articles by this author , Robert J HamiltonRobert J Hamilton More articles by this author , John KachuraJohn Kachura More articles by this author , Michael JewettMichael Jewett More articles by this author , Alexandre R ZlottaAlexandre R Zlotta More articles by this author , and Antonio FinelliAntonio Finelli More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002101.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Papillary Renal Cell Carcinomas (pRCC) are divided histologically into type 1 (pRCC1) and type 2 (pRCC2), but there are histological subtypes of pRCC that are unclassifiable (pRCCX). The subtypes cannot be discerned on imaging, but are clinically relevant: pRCC2 is associated with more aggressive disease, where pRCC1 carries a relatively low risk of metastases. Our objective was to evaluate the clinical and pathologic outcomes for biopsy-proven pRCC small renal masses (SRM) within our institutional database. METHODS: All SRM with a first pRCC histology at renal biopsy were included between 1994 to 2020 at Princess Margaret Cancer Centre, Toronto, Canada. Patients were evaluated for treatment strategy, follow-up, intervention, and pathologic concordance on subsequent nephrectomy. The pRCC was divided into pRCC1, pRCC2 and pRCCX if no subtype was specified. Active surveillance (AS) was defined as not undergoing intervention within 1 year of biopsy diagnosis. RESULTS: 178 SRM with biopsy-proven pRCC were identified. On their first diagnostic biopsy, 116 (65%) were pRCC1, 19 (11%) were pRCC2, and 43 (24%) were pRCCX. 52 (29%) had at least one follow-up biopsy and the median follow-up time was 42 months (IQR 21-76). The primary management strategy was surgery in 66 (37%), RFA in 52 (29%), and AS in 60 (34%) patients. Median age at biopsy was 64 and median size of the SRM was 2.4 cm (IQR 1.8 – 3). 71 patients underwent surgery either primarily or after AS or RFA. 4 patients managed with AS went on to have Nephrectomy and 6 AS patients had a subsequent RFA. Of the 40 patients with pRCC1 on biopsy, 32 (80%) had a pRCC1 on surgical pathology, of the 10 with pRCC2 on biopsy 30% had pRCC2 on surgical pathology, and of the 21 patients with pRCCX on biopsy 6 29% had pRCCX on surgical pathology. A total of 7 (10%) patients has other RCC on SP, Table 1. CONCLUSIONS: A biopsy of pRCC1 was highly predictive for pRCC1 on surgical pathology with no patients reclassifying to the more aggressive pRCC2, while 2 (5%) reclassified to other RCC. A biopsy with pRCC1 was much more correlated to a similar outcome on surgical pathology than pRCC2 and pRCCX. Only 10 (16%) patients shifted strategy from AS to treatment indicating it a reasonable strategy for the patients managed with AS in this cohort. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1085-e1086 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Johan Björklund More articles by this author Douglas C Cheung More articles by this author Robert J Hamilton More articles by this author John Kachura More articles by this author Michael Jewett More articles by this author Alexandre R Zlotta More articles by this author Antonio Finelli More articles by this author Expand All Advertisement Loading ...