You have accessJournal of UrologyKidney Cancer: Advanced (including Drug Therapy) II (PD39)1 Apr 2020PD39-10 LONG-TERM SURVIVORS WITH SARCOMATOID RENAL CELL CARCINOMA Kyle A. Blum*, Stanley Weng, Kate Weiss, Andrew W. Silagy, Renzo G. DiNatale, Julian Marcon, Roy Mano, Sounak Gupta, Satish K. Tickoo, Victor Reuter, Jonathan Coleman, Paul Russo, and A. Ari Hakimi Kyle A. Blum*Kyle A. Blum* More articles by this author , Stanley WengStanley Weng More articles by this author , Kate WeissKate Weiss More articles by this author , Andrew W. SilagyAndrew W. Silagy More articles by this author , Renzo G. DiNataleRenzo G. DiNatale More articles by this author , Julian MarconJulian Marcon More articles by this author , Roy ManoRoy Mano More articles by this author , Sounak GuptaSounak Gupta More articles by this author , Satish K. TickooSatish K. Tickoo More articles by this author , Victor ReuterVictor Reuter More articles by this author , Jonathan ColemanJonathan Coleman More articles by this author , Paul RussoPaul Russo More articles by this author , and A. Ari HakimiA. Ari Hakimi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000918.010AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Long term survival in sarcomatoid renal cell carcinoma (sRCC) is unusual with median survivals reported between 6-10 months. However, some patients live well past median estimates. While it is known that sRCC portends a poor prognosis, it is unknown why some patients survive longer than others with the same histology. We aim to evaluate characteristics associated with long-term survival for sRCC patients using a prospectively managed kidney cancer database. METHODS: After IRB approval, patients treated at Memorial Sloan Kettering Cancer Center for sRCC between 1982-2018 were identified. Pathology was reviewed by dedicated genitourinary pathologists. Patients were stratified into 2 groups: average and long-term survivors, based on a 3-year survival cutoff. Those who survived <3 years were defined as average survivors and those who survived ≥3 years were defined as long-term survivors. Patients lost to follow-up before 3 years were excluded. Non-time dependent characteristics, identified at initial diagnosis, were compared between the 2 groups and included sex, BMI, ASA score, margin status, TNM stage, tumor size, histology, and preoperative neutrophil-to-lymphocyte ratio (NLR) taken within 1 month prior to nephrectomy. Characteristics were analyzed using Mann-Whitney U-test and Fisher’s exact test. RESULTS: A total 362 sRCC patients were identified with a median age of 59.6 years (IQR 51.1-67.7) and comprised of 256 (70.7%) males. Patients had a median BMI of 26.4 (IQR 23.8-30.38), a median tumor size of 9cm (IQR 7.25-12.15) and 154 (42.5%) had metastasis at presentation. There were 256 (70.7%) average survivors, and 106 (29.3%) long-term survivors. In the M0 setting, long-term survivors had lower stage, negative margins, negative N status, and lower NLR, p<0.03. In the M1 setting, long-term survivors had clear-cell histology and lower NLR, p<0.001. Notably, long-term survivors had lower NLR in both the M0 and M1 setting, p<0.001, after correcting for stage and tumor size (Figure 1). CONCLUSIONS: sRCC long term survivors have lower NLR after correcting for sex, BMI, stage, tumor size, and margin status in the metastatic and non-metastatic setting. Our next steps will be to investigate the genomic and tumor-immune micorenvironment of these survivors. Source of Funding: NIH/NCI Cancer Center Support Grant P30 CA008748 © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e812-e813 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kyle A. Blum* More articles by this author Stanley Weng More articles by this author Kate Weiss More articles by this author Andrew W. Silagy More articles by this author Renzo G. DiNatale More articles by this author Julian Marcon More articles by this author Roy Mano More articles by this author Sounak Gupta More articles by this author Satish K. Tickoo More articles by this author Victor Reuter More articles by this author Jonathan Coleman More articles by this author Paul Russo More articles by this author A. Ari Hakimi More articles by this author Expand All Advertisement PDF downloadLoading ...