MP64-14 MAYO ADHESIVE PROBABILITY (MAP) SCORE IS ASSOCIATED WITH LOCALIZED RENAL CELL CARCINOMA PROGRESSION FREE SURVIVAL

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy III1 Apr 2016MP64-14 MAYO ADHESIVE PROBABILITY (MAP) SCORE IS ASSOCIATED WITH LOCALIZED RENAL CELL CARCINOMA PROGRESSION FREE SURVIVAL David Thiel, Andrew Davidiuk, Camille Meschia, Daniel Serie, Kaitlynn Custer, Steven Petrou, and Alex Parker David ThielDavid Thiel More articles by this author , Andrew DavidiukAndrew Davidiuk More articles by this author , Camille MeschiaCamille Meschia More articles by this author , Daniel SerieDaniel Serie More articles by this author , Kaitlynn CusterKaitlynn Custer More articles by this author , Steven PetrouSteven Petrou More articles by this author , and Alex ParkerAlex Parker More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.964AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The Mayo Adhesive Probability (MAP) score is a validated scoring system derived from cross-sectional imaging measurements of perinephric fat thickness and stranding used to predict adherent perinephric fat. Given previously studied links between inflammation and RCC tumorigenesis, we hypothesized that higher MAP scores are associated with poor renal cell carcinoma (RCC) outcomes. We assessed the association of MAP score and progression free survival (PFS) in patients with RCC. METHODS We identified 456 patients from a prospective registry surgically treated for localized RCC between 2002 and 2014. A single reviewer calculated pre-operative MAP scores (0-5) for each patient with pre-operative imaging. Kaplan-Meier (KM) curves were utilized to estimate PFS. Univariate and multi-variate cox proportional hazards models were used to estimate the association of MAP score with risk of progression, with adjustment for covariates such as age, body mass index (BMI), and SSIGN (Size, Stage, Grade, Necrosis) scores. RESULTS Patients with high MAP scores (4-5) were more likely to be male, older, have higher BMI, and larger tumor size (all p <0.01). High MAP scores are not associated with nodal status (p=0.28), tumor necrosis (p=0.37), sarcomatoid differentiation (p=0.33), or type of surgery ((nephrectomy vs. partial nephrectomy) p=0.71). Of our total cohort, 405 patients had MAP scores and follow up data to assess PFS. Dichotomizing MAP scores into high (MAP 4-5) and low (MAP 0-3) yields a hazard ratio of 2.16 for the 4-5 group versus 0-3 group (95% CI: 1.15-4.06, p=0.017). Adjustment for BMI did not alter the association (BMI-adjusted HR = 2.20 [1.07-4.52], p=0.032). Of interest, the association with MAP and PFS remains consistent among pathologic stage T1 RCC patients (n=287 (HR = 3.46 [1.06-11.24], p=0.039). CONCLUSIONS High MAP scores (4-5) are associated with decreased PFS in patients surgically treated for clinically localized RCC compared to patients with lower MAP scores (0-3). These findings indicate RCC aggressiveness may be associated with perinephric fat thickness and stranding. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e835 Advertisement Copyright & Permissions© 2016MetricsAuthor Information David Thiel More articles by this author Andrew Davidiuk More articles by this author Camille Meschia More articles by this author Daniel Serie More articles by this author Kaitlynn Custer More articles by this author Steven Petrou More articles by this author Alex Parker More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...