MP78-11 DO SARCOMATOID AND RHABDOID DIFFERENTIATION HAVE SIMILAR PROGNOSTIC EFFECTS FOR PATIENTS WITH GRADE 4 RENAL CELL CARCINOMA?

Abstract

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging II1 Apr 2016MP78-11 DO SARCOMATOID AND RHABDOID DIFFERENTIATION HAVE SIMILAR PROGNOSTIC EFFECTS FOR PATIENTS WITH GRADE 4 RENAL CELL CARCINOMA? Onder Kara, Homayoun Zargar, Matthew Maurice, Hiury Andrade, Oktay Akca, Peter Caputo, Daniel Ramirez, Ercan Malkoc, Brian Rini, and Jihad Kaouk Onder KaraOnder Kara More articles by this author , Homayoun ZargarHomayoun Zargar More articles by this author , Matthew MauriceMatthew Maurice More articles by this author , Hiury AndradeHiury Andrade More articles by this author , Oktay AkcaOktay Akca More articles by this author , Peter CaputoPeter Caputo More articles by this author , Daniel RamirezDaniel Ramirez More articles by this author , Ercan MalkocErcan Malkoc More articles by this author , Brian RiniBrian Rini More articles by this author , and Jihad KaoukJihad Kaouk More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1967AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The presence of sarcomatoid or rhabdoid elements within RCC has been reported to be associated with clinically poor outcomes. We aim to examine the impact of rhabdoid and sarcomatoid differentiation on cancer-specific survival (CSS) in patients with grade 4 renal cell carcinoma (RCC) undergoing extirpative surgery. METHODS We retrospectively analyzed our IRB-approved database of 1176 consecutive patients who underwent radical or partial nephrectomy for RCC between 2005 and 2013. We identified patients with Fuhrman grade IV RCC. The study cohort was divided into four groups: Grade IV without differentiation, Grade IV with rhabdoid features, Grade IV with sarcomatoid features, and Grade IV sarcomatoid and rhabdoid (mixed) features. The primary outcome was CSS, which was plotted by the Kaplan-Meier method and analyzed using the log-rank test and Cox proportional hazards modeling. RESULTS Of 264 patients with grade IV RCC, 159 (60.2%) had tumor differentiation, including 45 (28.3%) with rhabdoid only, 87 (54.7%) with sarcomatoid only, and 27 (16.9%) with both rhabdoid and sarcomatoid features (Table 1). Median CSS for the Grade IV group without tumor differentiation was 3.3 years (3.2-4.5) vs. 3.8 years (0.7-6.9) for the Grade IV-rhabdoid group (p=0.55). Median CSS for the Grade IV-sarcomatoid group and for the Grade IV-mixed group was 1.1 years (0.7-1.4) and 0.9 years (0.6-1.2), respectively, vs. 3.8 years (0.7-6.9) for the Grade IV-rhabdoid group (p=0.01 and p<0.01, respectively)(Figure 1). On multivariable analysis, there was a significant association between sarcomatoid differentiation and RCC death (HR 1.94; 95% CI 1.4-2.69; p<0.01); however, rhabdoid differentiation was no longer significant (HR 1.16; 95% CI 0.73-1.61; p=0.45). CONCLUSIONS Grade IV RCC with sarcomatoid differentiation is associated with worse CSS than grade IV RCC alone. Alternatively, rhabdoid differentiation does not appear to confer additional mortality risk for patients with grade 4 RCC. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1029-e1030 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Onder Kara More articles by this author Homayoun Zargar More articles by this author Matthew Maurice More articles by this author Hiury Andrade More articles by this author Oktay Akca More articles by this author Peter Caputo More articles by this author Daniel Ramirez More articles by this author Ercan Malkoc More articles by this author Brian Rini More articles by this author Jihad Kaouk More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...