Poster, Podium & Video Sessions
Presentation Authors: Diego Abreu*, Montevideo, Uruguay, Guillermo Gueglio, Patricio Garcia, Buenos Aires, Argentina, Walter da Costa, Daniel Beltrame, San Pablo, Brazil, Alvaro Zuñiga, Santiago, Chile, Luis Meza, Lima, Peru, Ruben Bengió, Cordoba, Argentina, Carlos Scorticati, Buenos Aires, Argentina, Ricardo Castillejos, Francisco Rodriguez, Ciudad de Mexico, Mexico, Ana Maria Autran, Carmen Gonzalez, Miguel Sanchez, Madrid, Spain, Jose Gadu, Ciudad de Mexico, Mexico, Alejandro Nolazco, Pablo Marinez, Carlos Ameri, Buenos Aires, Argentina, Hamilton Zampolli, San Pablo, Brazil, Raul Langenhin, Diego Muguruza, Paysandu, Uruguay, Marcos Tobias Machado, Antonio Lima Pompeo, San Pablo, Brazil, Pablo Mingote, Nicolas Ginéstar, Neuquén, Argentina, Matías López, Luján , Argentina, Boris Camacho, La Paz, Bolivia, Juan Yandian, Jorge Clavijo, Roberto Puente, Montevideo, Uruguay, Sergio de Miceu, Buenos Aires, Argentina, Lucas Nogueira, Carlos Corradi, Belo Horizonte, Brazil, Marcelo Torrico, Cochabamba, Bolivia, Martin Varela, Omar Clark, Montevideo, Uruguay, Luis Montes de Oca, Sebastian Savignano, Buenos Aires, Argentina, Ricardo Decia, Montevideo, Uruguay, Fernando Secin, Agustin Rovegno, Buenos Aires, Argentina, Gustavo Guimarães, Sidney Glina, San Pablo, Brazil, Joan Palau, Barcelona, Spain, Gustavo Carvalhal, Porto Alegre, Brazil, Philippe Spiess, Tampa, FL, Stenio Zequi, San Pablo, Brazil, Marston Linehan, Bethesda, MD
Introduction: Over the past several years, a major international study collaboration has occurred among centers of excellence caring for kidney cancer termed the Latin American Renal Cancer Group (LARCG). The aim of the present study is to assess the impact of clinical and pathologic variables on cancer specific survival (CSS) and overall survival (OS).
Methods: Analysis of data from 28 centers from 8 countries, revealed 4,060 patients with renal cell carcinoma (RCC) who underwent nephrectomy from 1990 to 2015, 530 of which (14.5%) had metastasis at clinical presentation. These are the focus of the present study. Median follow-up was six months (0-162). Of 455 patients with survival data, 203 died (44.6%), 184 (90.6%) of RCC.
Results: The median age of patients with metastatic RCC (mRCC) was 61 (23-71) years, 68% of patients were male and 32% female (2:1 ratio). The organs most frequently affected with metastasis were lungs (45.5%), bone (21.5%), lymph nodes (10.6%), liver (8.7%), adrenal (4%) and brain (2.2%). On univariate analysis, there were associations between 5-year OS and CSS and presence of ECOG-PS ≥1 (p=0.005 and p=0.007, respectively), ASA 3 classification (p<0.0001, for both), pT 3-4 (p=0.019 and p=0.009 respectively), pN1 (p=0.001 and p<0.0001), Fuhrman grades ≥3 (p=0.010 and p=0.008 respectively), Necrosis (p=0.024 and p=0.016), perirenal fat invasion (p<0.0001, for both), Hemoglobin <11 (p=0.001 and p=0.002), multiple metastases (p=0.002 and p=0.001), two or more involved organs (p=0.002 and p=0.005, respectively), bone vs pulmonary metastasis (p=0.017 and p=0.024), vertebral metastasis (p=0.035, for both), and more than five lungs metastases (p=0.003 for both). On multivariate analysis, the independent prognostic factor of 5-year OS was the ASA (p=0.020). Both OS and CSS were influenced by perirenal fat invasion (p=0.001 for both), and two or more metastatic organ sites (p<0.0001 and p=0.003 respectively).
Conclusions: This study of the impact of clinical and pathologic variables on survival in mRCC in Latin America was possible thanks to the collaborative work done by the LARCG. The presence of two or more sites of metastasis and the presence of perirenal fat invasion within the primary tumor predict shorter OS and CSS. ASA Classification was an independent predictor of OS.
Source Of Funding: None
Medicine Faculty Montevideo
Dr Diego Abreu, MD, Urologist, Member of the Pasteur Hospital Urology Service in Montevideo, Uruguay with a focus on Laparoscopy.
He is the founder and coordinator of the recently created Latin American Renal Cancer Group (L.A.R.C.G.). It is a non-profit group of scientific and educational, multicentric, multidisciplinary and independent. Consisting of Urologists, Pathologists and Oncologists, as well as professionals and researchers related to the field of health, belonging to 45 Hospitals in 8 countries in Latin America, Spain and the United States.
His principal objective is to establish a database on Renal Cancer, which allows to define regional characteristics: epidemiological, clinical, pathological, molecular and genetic.
The specific objective is the investigation of renal cancer in its broadest term, by searching for more accurate and reproducible tumor markers, for diagnostic purposes, prognosis and response to treatment.