PD52-06 MANAGEMENT LANDSCAPE OF RENAL CELL CARCINOMA IN SOLID ORGAN TRANSPLANT RECIPIENTS

Abstract

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging/Surveillance II (PD52)1 Sep 2021PD52-06 MANAGEMENT LANDSCAPE OF RENAL CELL CARCINOMA IN SOLID ORGAN TRANSPLANT RECIPIENTS Rishi Sekar, Sara Holt, John Gore, and George Schade Rishi SekarRishi Sekar More articles by this author , Sara HoltSara Holt More articles by this author , John GoreJohn Gore More articles by this author , and George SchadeGeorge Schade More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002079.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Immunosuppression in solid organ transplant recipients (SOTR) is thought to contribute to a higher incidence and adverse outcomes in various malignancies, including renal cell carcinoma (RCC). We evaluate the clinicopathologic characteristics and management landscape of RCC in SOTR. METHODS: Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare database, we identified patients diagnosed with localized RCC (2004-2015) with or without prior history of SOT (kidney, heart, lung, liver, pancreas, and intestine). Demographics, clinicopathological characteristics, and initial management strategies were compared between renal SOTR, non-renal SOTR and non-SOTR. Surgical management was defined as radical (RN) or partial nephrectomy (PN); non-surgical management was defined as cryotherapy/radiofrequency ablation (RFA) or surveillance. Multivariable logistic regression models and Cox proportional hazards models were utilized for group comparisons. RESULTS: We identified 31,195 patients with localized RCC, of whom 335 (1.1%) had a history of SOT. Compared with non-SOTR, SOTR were younger (mean 72.6 vs. 75.2 years, p<0.001), more medically complex (Charlson Comorbidity Index ≥ 3 in 62.7% vs. 18.2%, p<0.001), more likely to present with T1a disease (60.0% vs. 47.9%, p<0.001), and had similar time to definitive intervention (60.4 vs. 51.1 days). There were no significant differences between renal (n=279) and non-renal SOTR (n=56). Initial treatment strategy is presented in Figure 1. Renal SOTR were significantly more to likely to undergo surgery than non-SOTR (HR 1.63, CI 1.21–2.21) and non-renal SOTR (HR 2.06, 1.10–3.99), and significantly more likely to undergo RN versus PN than non-SOTR (HR 3.73, CI 2.47–5.61) and non-renal SOTR (HR 3.46, CI 1.47–8.10). Conversely, when compared to non-SOTR, non-renal SOTR had a trend towards conservative management (HR 0.75, CI 0.42–1.32), and PN versus RN (HR 0. 76, CI 0.37–1.32). CONCLUSIONS: Among Medicare beneficiaries, SOTR presented with RCC at an earlier age and stage. In comparison with non-SOTR, management varied significantly based on transplant type with renal SOTR managed more surgically and with RN, and non-renal SOTR managed more conservatively or with PN. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e912-e913 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rishi Sekar More articles by this author Sara Holt More articles by this author John Gore More articles by this author George Schade More articles by this author Expand All Advertisement Loading ...