MP72-05 PATTERNS AND PREDICTORS OF RECURRENCE AFTER PARTIAL NEPHRECTOMY FOR KIDNEY TUMORS

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy V1 Apr 2017MP72-05 PATTERNS AND PREDICTORS OF RECURRENCE AFTER PARTIAL NEPHRECTOMY FOR KIDNEY TUMORS Pascal Mouracade, Onder Kara, Matthew Maurice, Julien Dagenais, Ercan Malkoc, Jaya Sai Chavali, Ryan Nelson, Khaled Fareed, Robert Stein, Amr Fergany, and Jihad Kaouk Pascal MouracadePascal Mouracade More articles by this author , Onder KaraOnder Kara More articles by this author , Matthew MauriceMatthew Maurice More articles by this author , Julien DagenaisJulien Dagenais More articles by this author , Ercan MalkocErcan Malkoc More articles by this author , Jaya Sai ChavaliJaya Sai Chavali More articles by this author , Ryan NelsonRyan Nelson More articles by this author , Khaled FareedKhaled Fareed More articles by this author , Robert SteinRobert Stein More articles by this author , Amr FerganyAmr Fergany More articles by this author , and Jihad KaoukJihad Kaouk More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2241AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The last years have been marked by a growth in the use of partial nephrectomy (PN) for complex renal masses. This has led to an overall increase in the number of tumors found to have adverse pathological features. The aim of this study was to identify patterns and predictors of recurrence in patients with clinically localized renal cell carcinoma managed with PN. METHODS Retrospective study of 830 consecutive cases of PN done between 2007 and 2015 at a single institution. Patient demographics, and pathological characteristics were correlated with recurrence patterns (overall, local and distant) and overall survival (OS) using Kaplan-Meier and cox regression analyses. Differences in the recurrence patterns were evaluated. RESULTS Median age was 61 years, and median tumor size was 3.1 cm. Overall, 11.6% of tumors were pT3 stage, 39.3% were high grade, 2.9% had lymphovascular invasion, and 7.1% had positive margins. Median follow up was 36 months. There were 5.8% of patients diagnosed with recurrence. Grade, stage, surgical margins, and R.E.N.A.L score were associated with shorter disease-free survival (DFS). In multivariable regression pT (p<0.01), grade (p<0.01), and R.EN.A.L score (p=0.02) remain independent predictors of DFS. pT stage (HR 4.9, p<0.01) and grade (HR 3.9, p<0.01) were predictors of metastasis, while R.E.N.A.L score (HR 3.86, p=0.03) was the single predictor of local recurrence. Positive surgical margin did not predict recurrence. Five-year DFS and OS probabilities were 91% and 94%, respectively. Local recurrence emerged and developed earlier than metastasis (median 13 vs. 22 months, p<0.01). CONCLUSIONS High pT stage, high grade, and high R.E.N.A.L. score increase the risk of disease recurrence after partial nephrectomy. pT stage and grade are predictors of metastasis while R.E.N.A.L. score predicts local recurrence. Surgical margin status did not predict disease recurrence. The relapse features and risk factors are different between the 2 recurrence patterns. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e955-e956 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Pascal Mouracade More articles by this author Onder Kara More articles by this author Matthew Maurice More articles by this author Julien Dagenais More articles by this author Ercan Malkoc More articles by this author Jaya Sai Chavali More articles by this author Ryan Nelson More articles by this author Khaled Fareed More articles by this author Robert Stein More articles by this author Amr Fergany More articles by this author Jihad Kaouk More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...