Moderated Poster

Poster, Podium & Video Sessions

MP22-02: Synergistic prognostic impact of elevated de ritis ratio and RENAL score for prediction of survival outcomes in renal cell carcinoma after surgical treatment

Friday, May 12
3:30 PM - 5:30 PM
Location: BCEC: Room 253AB

Presentation Authors: Aaron Bloch, Zachary Hamilton*, Charles Field, Katherine Fero, Sean Berquist, Abd−elrahma Hassan, Brittney Cotta, Daniel Han, Richmond Owusu, Sunil Patel, Fang Wan, James Proudfoot, Ithaar Derweesh, San Diego, CA

Introduction: Renal Cell Carcinoma (RCC) is a metabolically driven neoplasm. Inflammatory markers and morphometric measures have been suggested to be predictive for prognosis. We investigated the impact of a novel combination of preoperative tumor morphology (RENAL score) and a laboratory based inflammatory marker (DeRitis Ratio, AST/ALT) on survival outcomes in localized RCC.

Methods: Single center, retrospective analysis of 524 patients with RCC (312 PN, 212 RN, mean follow up 35.8 months) from 2003-2015. A priori, we assigned a positive marker score of 1 if RENAL >8 or DeRitis >1.5. Patients were stratified by increasing positive markers (0=RENAL ≤8 and DeRitis ≤1.5, 1=RENAL >8 or DeRitis >1.5, 2=RENAL >8 and DeRitis>1.5). Primary outcome was overall survival (OS). Cox models and Kaplan-Meier curves were utilized.

Results: 524 patients, 68% male, mean age 64.8 ± 12.6 years, mean BMI 29.1 ± 6.5, mean DeRitis 1.1 ± 0.4. With regards to tumor characteristics, mean clinical tumor size was 4.8 ± 3.3cm and median RENAL score was 8 (IQR 6-10). For clinical staging, 74% were cT1, 19% cT2, and 6% were >T2. On Cox model for OS, RENAL >8 (HR 1.95, p=0.003) and DeRitis >1.5 (HR 3.74, p<0.001) were significantly associated with worsened survival. On Cox model output for OS and marker score, we found 1 marker (HR 1.83, p=0.011) and 2 markers (HR 7.68, p<0.001) were significantly associated with worsened survival (figure).

Conclusions: Novel combination of a morphological score (RENAL) and an inflammatory marker (DeRitis ratio) was associated with worsened OS in RCC after surgical treatment. Our findings point towards development and validation of a prognostic index to assist in risk stratification and follow up protocols for RCC.

Source Of Funding: Stephen Weissman Kidney Cancer Research Fund
NIH grants UL1TR000100 and UL1TR001442

Zachary Hamilton, MD

University of California, San Diego

Dr. Zachary Hamilton completed medical school at the University of Missouri - Columbia. He then completed residency in urology at the University of Kansas - Kansas City. He is currently completing an SUO fellowship in urologic oncology at the University of California - San Diego and has accepted an academic position at Saint Louis University. His interests include urologic oncology and robotic surgery.

Presentation(s):

Send Email for Zachary Hamilton


Assets

MP22-02: Synergistic prognostic impact of elevated de ritis ratio and RENAL score for prediction of survival outcomes in renal cell carcinoma after surgical treatment



Attendees who have favorited this

Send Email for Synergistic prognostic impact of elevated de ritis ratio and RENAL score for prediction of survival outcomes in renal cell carcinoma after surgical treatment