PD12-07 PREDICTORS OF PATHOLOGICALLY NODE POSITIVE DISEASE IN PATIENTS UNDERGOING RETROPERITONEAL LYMPH NODE DISSECTION (RPLND) FOR RENAL CELL CARCINOMA (RCC): RESULTS FROM THE CANADIAN KIDNEY CANCER COLLABORATION

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy II1 Apr 2018PD12-07 PREDICTORS OF PATHOLOGICALLY NODE POSITIVE DISEASE IN PATIENTS UNDERGOING RETROPERITONEAL LYMPH NODE DISSECTION (RPLND) FOR RENAL CELL CARCINOMA (RCC): RESULTS FROM THE CANADIAN KIDNEY CANCER COLLABORATION Andrea Kokorovic, Rodney Breau, Antonio Finelli, Simon Tanguay, Anil Kapoor, Jun Kawakami, Adrian Fairey, Alan So, Darrel Drachenberg, Luke T. Lavallée, Jean-Baptiste Lattouf, Frederic Pouliot, Ranjeeta Mallick, and Ricardo A. Rendon Andrea KokorovicAndrea Kokorovic More articles by this author , Rodney BreauRodney Breau More articles by this author , Antonio FinelliAntonio Finelli More articles by this author , Simon TanguaySimon Tanguay More articles by this author , Anil KapoorAnil Kapoor More articles by this author , Jun KawakamiJun Kawakami More articles by this author , Adrian FaireyAdrian Fairey More articles by this author , Alan SoAlan So More articles by this author , Darrel DrachenbergDarrel Drachenberg More articles by this author , Luke T. LavalléeLuke T. Lavallée More articles by this author , Jean-Baptiste LattoufJean-Baptiste Lattouf More articles by this author , Frederic PouliotFrederic Pouliot More articles by this author , Ranjeeta MallickRanjeeta Mallick More articles by this author , and Ricardo A. RendonRicardo A. Rendon More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.643AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES A randomized trial demonstrated that patients with clinically low risk RCC do not benefit from RPLND, but the role of RPLND at time of nephrectomy for higher risk tumors remains controversial. We hypothesize that patients with locally advanced disease have a worse prognosis and may benefit from nodal dissection. Here we identify predictors of pathologically node positive (pN1) disease in patients treated with RPLND at time of nephrectomy. METHODS We analyzed data from a prospectively maintained multi-institutional cohort of patients in the Canadian Kidney Cancer Information System (CKCis) who underwent nephrectomy for RCC with or without RPLND from 2011 to 2017. Analysis was used to determine: (a) preoperative predictors of undergoing RPLND (b) predictors of pN1 in patients receiving RPLND. RESULTS 6084 patients with cTanyNanyMany RCC treated with partial (N=2788) or radical (N=3296) nephrectomy were identified. 886 (16%) patients had clinical T3-T4 disease, 322 (6%) had clinically positive nodes (cN1) and 504 (9%) had metastatic (M1) disease. 1777 (29%) patients underwent RPLND. Of patients treated with RPLND, 248 (14%) had pN1 disease. Patients with ECOG performance status (PS) >1, larger tumor size, stages cT2-T4 vs. T1, cN1, M1 and histologic grades 3-4 were more likely to undergo RPLND at time of surgery. Predictors of pN1 disease were BMI 20-30 vs. BMI >30, ECOG PS >1, larger tumor size, stages cT2-T4 vs. cT1, cN1, M1, histologic grades 3-4, and non-clear cell histology (Table 1). CONCLUSIONS In the largest study of its kind to date, several risk factors for pN1 status were identified. Of interest, BMI 20-30 and non-clear cell histology have not been previously identified as predictors of pN1 disease and may therefore represent a novel subset of patients that could benefit from nodal dissection. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e241 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Andrea Kokorovic More articles by this author Rodney Breau More articles by this author Antonio Finelli More articles by this author Simon Tanguay More articles by this author Anil Kapoor More articles by this author Jun Kawakami More articles by this author Adrian Fairey More articles by this author Alan So More articles by this author Darrel Drachenberg More articles by this author Luke T. Lavallée More articles by this author Jean-Baptiste Lattouf More articles by this author Frederic Pouliot More articles by this author Ranjeeta Mallick More articles by this author Ricardo A. Rendon More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...