PD41-02 NOMOGRAM TO PREDICT RECURRENCE IN NON-METASTATIC RCC WITH THROMBUS USING A MULTI-CENTER CONTEMPORARY SERIES

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV1 Apr 2016PD41-02 NOMOGRAM TO PREDICT RECURRENCE IN NON-METASTATIC RCC WITH THROMBUS USING A MULTI-CENTER CONTEMPORARY SERIES Michael L. Blute, Timothy A. Masterson, Viraj A. Master, Vitaly Margulis, C. Adam Lorentz, Tyler M. Bauman, Jose A. Karam, Christopher G. Wood, and E. Jason Abel Michael L. BluteMichael L. Blute More articles by this author , Timothy A. MastersonTimothy A. Masterson More articles by this author , Viraj A. MasterViraj A. Master More articles by this author , Vitaly MargulisVitaly Margulis More articles by this author , C. Adam LorentzC. Adam Lorentz More articles by this author , Tyler M. BaumanTyler M. Bauman More articles by this author , Jose A. KaramJose A. Karam More articles by this author , Christopher G. WoodChristopher G. Wood More articles by this author , and E. Jason AbelE. Jason Abel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1548AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Risk factors for recurrence after surgery for non-metastatic RCC patients with tumor thrombus are poorly defined. The purpose of this study is to develop a clinically relevant nomogram in non-metastatic RCC patients with tumor thrombus using contemporary data from 5 centers to predict disease recurrence following radical nephrectomy and tumor thrombectomy. METHODS Data was collected for consecutive non-metastatic RCC patients with tumor thrombus treated surgically from 2000-2012 at the University of Wisconsin, UTSW, MD Anderson, Emory University, and Indiana University. Multivariate proportional hazard models and competing risk analyses evaluated associations with recurrence and variables including: age, BMI, gender, smoking, local or systemic symptoms, surgery year, laterality, preoperative labs, EBL, transfusion, thrombus level, T-stage, tumor diameter, perinephric fat invasion, histologic subtype, and sarcomatoid features. A nomogram was developed to identify patients at greatest risk of RCC recurrence. RESULTS Of 637 patients, 239 (37.5%) progressed to metastatic disease within a median follow-up of 24.9 Months (IQR 12.2-54.9). Tumor thrombus extended into the renal vein in 300 (47.1%), IVC below the diaphragm 280 (44%), and IVC above the diaphragm 57 (8.9%). Nomogram was developed from variables that were significant after multivariate analysis and included BMI and tumor size as continuous variables. Categorical variables include: hemoglobin <LLN, peri-nephric fat invasion, non-clear cell histology and systemic symptoms. The predictive accuracy of the nomogram was calculated (AUC 0.72) and decision curve analysis was performed. CONCLUSIONS Using a multicenter contemporary dataset, a nomogram was developed that predicts tumor recurrence in non-metastatic RCC patients with thrombus. This model can be used for individualize follow-up regimens and to identify patients for enrollment in adjuvant clinical trials. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e940 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Michael L. Blute More articles by this author Timothy A. Masterson More articles by this author Viraj A. Master More articles by this author Vitaly Margulis More articles by this author C. Adam Lorentz More articles by this author Tyler M. Bauman More articles by this author Jose A. Karam More articles by this author Christopher G. Wood More articles by this author E. Jason Abel More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...