Page 4 - CUA2018 Abstracts - Oncology-Bladder

Poster session 5: Other Oncology I

MP–5.9 analysis was performed to predict covariates associated with recurrence.
Morphological subtyping as a prognostic predictor for survival Results: A total of 128 UTUC patients were found, 98 with DnUTUC
in papillary renal cell carcinoma: Type 1 vs. type 2 (76.5%) and 30 with SUTUC (23.5%). Mean age and the number of males
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Richard Di Lena , Emily Wong , Anil Kapoor , Frédéric Pouliot , Antonio were similar (70.5 vs. 69.1; p=0.548, and 83.3% vs. 70.4%; p=0.161, for
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Finelli , Simon Tanguay , Alan So , Ricardo Rendon , Luke Lavallee , Jun DnUTUC vs. SUTUC, respectively). However, DnUTUC patients had a
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Kawakami , Jean–Baptiste Lattouf , Ranjeeta Mallick , Rodney Breau 7 lower age–adjusted Charlson score (6.4 vs. 7.5; p=0.039). In both groups,
1 Urology, McMaster University, Hamilton, ON, Canada; Urology, 70% of patients had high–grade (HG) disease, more than 43% had Ta
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Université Laval, Quebec City, QC, Canada; Urology, University Health disease, and more than 37% had T2 and above disease. Interestingly, car-
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Network, Toronto, ON, Canada; Urology, McGill University Health cinoma in situ (CIS) and recurrence rates were much higher in SUTUC than
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Centre, Montreal, QC, Canada; Urology, University of British Columbia, in DnUTUC (56.7% vs. 25.5%; p=0.001, and 70.4% vs. 39.8%; p=0.005,
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Vancouver, BC, Canada; Urology, Dalhousie University, Halifax, NS, respectively). Treatment strategy was similar, with more than 80% under-
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Canada; Urology, The Ottawa Hospital, Ottawa, ON, Canada; Southern going nephroureterectomy in both groups. Cancer–specific survival (CSS)
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Alberta Institute of Urology, University of Calgary, Calgary, AB, Canada; was significantly better in DnUTUC, with 11.5% vs. 32.1% dying of their
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9 Urology, Université de Montréal, Montreal, QC, Canada; Ottawa disease (p=0.058). Multivariable logistic regression analysis demonstrated
Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada that male gender and SUTUC disease significantly predicted recurrence.
Introduction: Papillary renal cell carcinoma (pRCC) is the second most Conclusions: In this single–centre experience spanning more than a
common RCC and is subclassified into type 1 and 2. The independent decade, DnUTUC disease has been shown to be the more common
prognostic value of pRCC subtype remains controversial. The present study UTUC variant, with the majority of patients having HG disease. In this
evaluated cancer–related outcomes of patients with clinically localized specific entity, CIS and recurrence rates are significantly lower and sur-
pRCC who are treated with radical or partial nephrectomy. vival rates are considerably better when compared to SUTUC. These
Methods: This is a nested cohort of the prospective Canadian Kidney findings raise the question whether followup strategies for recurrence
Cancer information system database from 16 institutions between 2011 should differ between DnUTUC and SUTUC.
and 2017. Patient, diagnosis, treatment, and survival characteristics were
compared between pRCC type 1 and 2 cohorts. MP–5.11
Results: During the study period, 607 patients had clinically localized Diabetes and kidney cancer survival in patients undergoing
pRCC type 1 (n=383) or type 2 (n=224) histology. Age, sex, race, and nephrectomy: A Canadian multicentre, propensity score analysis
comorbidities were balanced between groups. Pathological stage (pT3 or Madhur Nayan , Shreya Jalali , Anil Kapoor , Antonio Finelli , Alan So ,
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4) and Fuhrman’s nuclear grade (3 or 4) were significantly higher in the Ricardo Rendon , Rodney Breau , Luke Lavallee , Simon Tanguay , Daniel
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type 2 pRCC cohort (p<0.0001). pRCC type 2 tumours were significantly Heng , Jun Kawakami , Naveen Basappa , Georg Bjarnason , Frédéric
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larger compared to type 1 (4.0 cm [interquartile range (IQR) 2.7–6.0) Pouliot , Robert Hamilton 1
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vs. 3.5 cm [IQR 2.2–5.0]; p=0.002), although size was not an indepen- 1 Division of Urology, Departments of Surgery and Surgical Oncology,
dent predictor of subtype (p=0.84). A greater proportion of type 2 pRCC University of Toronto, Toronto, ON, Canada; Division of Urology,
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patients received radical nephrectomy (46.9% vs. 26.4%; p<0.0001). McMaster University, Hamilton, ON, Canada; Department of Urologic
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Significantly more type 2 pRCC patients underwent lymph node dis- Sciences, University of British Columbia, Vancouver, BC, Canada;
section (LND) (31.7% vs. 17.1%; p<0.0001) and had more pathologi- 4 Department of Urology, Dalhousie University, Halifax, NS, Canada;
cally positive nodes (27.5% vs. 4.7%; p=0.0004). Overall, type 2 pRCC 5 Division of Urology, University of Ottawa, Ottawa, ON, Canada; Division
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had worse cancer outcomes compared to type 1, as demonstrated by of Urology, McGill University, Montreal, QC, Canada; Department of
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elevated all–cause mortality (hazard ratio [HR] 4.76; 95% confidence Oncology, University of Calgary, Calgary, AB, Canada; Division of
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interval [CI] 2.40–9.41; p<0.0001) and worse progression–free survival Urology, University of Calgary, Calgary, AB, Canada; Department of
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(HR 5.92; 95% CI 3.34–10.51; p<0.0001) (Fig. 1; available at https://cua. Oncology, University of Alberta, Edmonton, AB, Canada; Department
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guide/). After surgery, patients with type 2 pRCC were more commonly of Medical Oncology, University of Toronto, Toronto, ON, Canada;
treated with systemic therapy (11.2% vs. 0.8%) or radiation to metastases 11 Division of Urology, Université Laval, Quebec City, QC, Canada;
(5.8% vs. 0%) (p<0.0001). At last followup, significantly more type 2 12 Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
patients developed metastatic disease (18% vs. 2%; p<0.0001). Introduction: Diabetes has been associated with an adverse prognosis
Conclusions: This is the largest cohort study comparing pRCC subtypes. in various malignancies; however, there are conflicting data in kidney
Clinically localized type 2 pRCC is associated with unfavourable prognosis. cancer. Furthermore, it has been shown that diabetics tend to receive less
aggressive cancer treatment. Determining whether diabetes is associated
MP–5.10 with survival in kidney cancer may help guide treatment in a comorbid
Differences between patients with de novo vs. secondary upper patient population.
tract urothelial carcinoma: The Princess Margaret Cancer Centre Methods: We used the Canadian Kidney Cancer Information System data-
experience base to identify patients undergoing a nephrectomy from 1989–2017 for
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Douglas C. Cheung , Hanan Goldberg , Zachary Klaassen , Thenappan M0 renal cell carcinoma at 16 institutions across Canada. We derived
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Chandrasekar , Rashid Sayyid , Andrew Evans , Thoedorus van der Kwast , inverse probability of treatment weights (IPTW) from a propensity score
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Girish Kulkarni , Robert Hamilton , Alexandre Zlotta , Nathan Perlis , model based on various clinical, surgical, and pathological characteristics.
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Antonio Finelli , Neil Fleshner 1 We used Cox proportional hazard models to evaluate the association
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1 Princess Margaret Cancer Centre, University Health Network, Toronto, between diabetes and cancer–specific and overall survival, in the sample
ON, Canada weighted by the IPTW.
Introduction: Upper tract urothelial carcinoma (UTUC) accounts for <5% Results: We identified 4828 patients that met inclusion criteria, of whom
of all urothelial cancers (UC). It is usually considered a part of the spec- 948 (19.6%) were diabetic. Median followup in those without death was
trum of UC, manifesting as bladder cancer (BCa) primarily. Our objec- 26.6 months (interquartile range [IQR] 9.7–53.8). There were 901 deaths
tive was to find whether there are clinical differences between UTUC from any cause and 299 deaths from kidney cancer. Before propensity
tumours that present de novo (DnUTUC) and those that present second- score methods, diabetics were older, more likely to have a history of
arily (SUTUC) (i.e., having had a prior history of BCa). concomitant comorbidities, and more likely to have clear–cell renal cell
Methods: The Princess Margaret Cancer Centre institutional database was carcinoma. After propensity score methods, all characteristics were bal-
queried for all UTUC patients between 2002 and 2016. Data collected anced between groups (standardized difference <0.10). IPTW–adjusted
included clinical, pathological, and followup parameters. Patients were Cox proportional hazard models demonstrated no significant associa-
stratified according to whether their disease was DnUTUC or SUTUC. tion between diabetes and cancer–specific (hazard ratio [HR] 1.05; 95%
Survival outcomes were compared and multivariate logistic regression confidence interval [CI] 0.77–1.45), or overall survival (HR 1.09; 95%
CI 0.91–1.31).
S92 CUAJ • June 2018 • Volume 12(6Suppl2)