MAYO CLINIC VALIDATION OF THE AMERICAN UROLOGIC ASSOCIATION RISK GROUPS FOR LOCALIZED RENAL CANCER

You have accessJournal of UrologyCME1 May 2022MP47-03 MAYO CLINIC VALIDATION OF THE AMERICAN UROLOGIC ASSOCIATION RISK GROUPS FOR LOCALIZED RENAL CANCER Andrew Zganjar, Abhinav Khanna, Dan Joyce, Paige Nichols, Christine Lohse, John Cheville, Sounak Gupta, Aaron Potretzke, R. Houston Thompson, Bradley Leibovich, Stephen Boorjian, and Vidit Sharma Andrew ZganjarAndrew Zganjar More articles by this author , Abhinav KhannaAbhinav Khanna More articles by this author , Dan JoyceDan Joyce More articles by this author , Paige NicholsPaige Nichols More articles by this author , Christine LohseChristine Lohse More articles by this author , John ChevilleJohn Cheville More articles by this author , Sounak GuptaSounak Gupta More articles by this author , Aaron PotretzkeAaron Potretzke More articles by this author , R. Houston ThompsonR. Houston Thompson More articles by this author , Bradley LeibovichBradley Leibovich More articles by this author , Stephen BoorjianStephen Boorjian More articles by this author , and Vidit SharmaVidit Sharma More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002618.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The prognosis of patients treated with surgery for localized renal cell carcinoma (RCC) is associated with multiple factors, which has led to the development of prognostic models to predict progression-free survival (PFS) and cancer-specific survival (CSS). The AUA guidelines recently introduced a new risk group stratification system based on tumor stage and grade to guide surveillance after surgery. We sought to evaluate the new AUA risk groups using PFS and CSS at the suggested follow-up intervals and then compare its performance to that of our published institutional risk models. METHODS: We queried our Nephrectomy Registry to identify adults treated with radical or partial nephrectomy for unilateral, M0, clear cell RCC or papillary RCC from 1980–2012. Chromophobe RCC was excluded because the AUA risk groups rely on tumor grade but the WHO/ISUP does not endorse grading this subtype. PFS and CSS were estimated using the Kaplan-Meier method. Predictive abilities were evaluated using c-indexes from Cox proportional hazards regression models. RESULTS: 3,191 patients with clear cell RCC and 633 patients with papillary RCC were included with a median follow-up of 144 and 118 months, respectively. PFS rates by AUA risk group for patients with clear cell RCC and papillary RCC are summarized in Table 1 and (for clear cell RCC) Figure 1. For patients with clear cell RCC, c-indexes for the AUA risk groups and our model were 0.780 and 0.815, respectively (p <0.001) for PFS, and 0.811 and 0.857, respectively (p <0.001), for CSS. For patients with papillary RCC, c-indexes for the AUA risk groups and our model were 0.775 and 0.751, respectively (p=0.002) for PFS, and 0.830 and 0.803, respectively (p=0.2) for CSS. CONCLUSIONS: The new AUA risk stratification system has robust c-indexes for PFS and CSS in patients with clear cell RCC and papillary RCC after surgery for localized RCC. A limitation of the AUA risk stratification system is that it does not apply to chromophobe RCC as it relies on tumor grade, yet the WHO/ISUP does not currently endorse grading chromophobe RCC. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e809 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrew Zganjar More articles by this author Abhinav Khanna More articles by this author Dan Joyce More articles by this author Paige Nichols More articles by this author Christine Lohse More articles by this author John Cheville More articles by this author Sounak Gupta More articles by this author Aaron Potretzke More articles by this author R. Houston Thompson More articles by this author Bradley Leibovich More articles by this author Stephen Boorjian More articles by this author Vidit Sharma More articles by this author Expand All Advertisement PDF downloadLoading ...