Page 7 - CUA2018 Abstracts - Oncology-Testis

Poster session 12: Other Oncology III

had more synchronous disease (44.3% vs. 28.9%; p<0.01), were treated 9 Section of Urology, Université de Montréal, Montreal, QC, Canada;
more frequently with targeted therapy (70.9% vs. 40%; p<0.0001) and 10 Dalla Lana School of Public Health, University of Toronto, Toronto,
had more bone metastasectomy (29.1% vs. 14.5%; p<0.01). The five–year ON, Canada
OS of patients receiving complete and incomplete metastasectomy was Introduction: The primary objective of this study was to study risk fac-
59% and 28%, respectively (p<0.001). Having a metastasectomy for brain tors and outcomes in patients who underwent radical nephrectomy (RN)
(hazard ratio [HR] 3.17; 95% confidence interval [CI] 1.32–7.60), liver for renal cell carcinoma (RCC) where tumour invaded beyond Gerota’s
(HR 5.64; 95% CI 1.22–25.98), or bones (HR 1.92; 95% CI 0.99–3.74) fascia, including contiguous extension into the ipsilateral adrenal gland
metastasis, as well as having received prior targeted therapy (HR 5.45; (pT4). There is little data on the outcome of this specific subset of patients.
95% CI 2.76–10.81) were all associated with higher risk of mortality. Methods: From 2009 to 2016, we identified 82 patients in the multicentre
Yet, having received targeted therapy prior to metastasectomy was not Canadian Kidney Cancer information system (CKCis) who underwent RN
associated with the progression (HR 1.06; 95% CI 0.5–1.9). Having a and were found to have pT4 RCC. Clinical, operative, and pathological
complete metastasectomy was independently associated with survival variables were analyzed with univariate and multivariable Cox propor-
(HR 0.44; 95% CI 0.24–0.81). tional hazard models to identify relevant factors associated with overall
Conclusions: Patients undergoing complete metastasectomy have better survival. Survival curves were estimated according to Kaplan–Meier meth-
prognosis of survival than patient undergoing incomplete metastasectomy. ods and compared using the log–rank test.
Sites of metastasectomy, such as brain, liver, or bones metastasis, were Results: Median patient age was 62 years. Twenty–three (28%) patients
associated with a poorer survival. had clinical stage T4 preoperatively, 20 (24%) had clinical N1 disease,
and 33 (40%) had clinical M1 disease. There were 27 (33%) patients
UP–12.3 with pN1 and 32 (39%) were pM1. Median postoperative followup was
12 months (interquartile range [IQR] 3, 24). At last followup, eight (10%)
Outcomes and prognosticators of pathological T4 renal cell patients were alive with no evidence of disease, 27 (33%) are alive with
carcinoma: Results from Canadian Kidney Cancer information disease, and 36 (44%) died of disease. Patients with sarcomatoid charac-
system (CKCis) teristics (p=0.027) (Fig. 1; available at https://cua.guide/), non–clear–cell
Justin Oake , Premal Patel , Ricardo Rendon , Antonio Finelli , Anil histology (p=0.03), and presence of systemic symptoms (p=0.045) had a
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Kapoor , Jun Kawakami , Ronald Moore , Alan So , Laurence Klotz , Luke significantly worse overall survival. Tumour histological subtype (clear–
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Lavallee , Jean–Baptiste Lattouf , Olli Saarela , Darrel Drachenberg 1 cell vs. non–clear–cell) (p=0.0032), tumour size (cm) (p=0.012), and
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1 Section of Urology, University of Manitoba, Winnipeg, MB, Canada;
2 Department of Urology, Dalhousie University, Halifax, NS, Canada; Fuhrman grade (G4 vs. G2–G3) (p=0.045) were significantly associated
3 Division of Urology, University of Toronto, Toronto, ON, Canada; with overall survival in multivariable Cox regression.
4 Division of Urology, McMaster University, Hamilton, ON, Canada; Conclusions: For patients with pT4 RCC after RN, survival is poor. More
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5 Division of Urology, University of Calgary, Calgary, AB, Canada; Section than three–quarters of patients (78%) were clinically understaged com-
pared to their final pathology. Sarcomatoid features, non–clear–cell his-
of Urology, University of Alberta, Edmonton, AB, Canada; Department tology, and presence of systemic symptoms in particular were associated
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of Urologic Sciences, University of British Columbia, Vancouver, BC, with worse overall survival.
Canada; Division of Urology, University of Ottawa, Ottawa, ON, Canada;
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S136 CUAJ • June 2018 • Volume 12(6Suppl2)