ORLANDO, FL USA (UroToday.com) - When detecting organ-confined disease, clear cell renal cell carcinoma (ccRCC) is primarily treated surgically, however, close follow-up should aim to detect recurrence.
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Cell cycle progression (CCP) genes, responsible for controlling cell division and replication, may be variably expressed and have some value in describing prostate cancer behavior, among others. The authors aimed to determine the prognostic value of CCP gene expression profile for determining ccRCC progression on surgically resected tumors.
They retrospectively reviewed the medical records of 26 patients with ultimately metastatic (within 5 years) organ-confined ccRCC treated with resection who lacked metastasis or lymph node involvement at the time of surgery, excluding those with T2a-T3b tumors. Thirty-eight controls with no less than 4.5 years of follow-up without recurrence were compared. RNA was extracted from tumor specimens, and 31 cell cycle genes and 15 control genes were evaluated, and following normalization, were used to generate a CCP score. Other variables analyzed included patient sex, age at surgery, tumor stage, Fuhrman nuclear grade (FNG), tumor size, smoking status, lymphovascular invasion (LVI), follow-up, and time to metastasis. Univariate and multivariate logistic regression models evaluated the association of CCP score and clinical parameters with metastatic progression.
Among 26 cases, median time to metastasis was 1.7 years, while controls had median follow-up of 6.7 years. Bivariate analysis demonstrated LVI, FNG, and CCP score were associated with metastasis; on multivariate logistic regression, age, tumor size, and CCP score were associated. Step-wise multivariate selection procedures demonstrated that age, CCP, tumor size, and LVI were more predictive (AUC=0.84) in combination than if CCP was excluded (AUC=0.78).
The authors suggest that cell cycle progression score may offer additional prognostic value in predicting metastasis after resection of organ-confined ccRCC. Further analyses will seek to determine whether this test may also add a benefit of stratifying patients for active surveillance by analyzing biopsy specimens from small renal masses.
Click HERE to view the poster from this session
Presented by Eric Askeland at the American Urological Association (AUA) Annual Meeting- May 16 - 21, 2014 - Orlando, Florida USA
University of Iowa, Iowa City, IA USA
Written by Eric Ballon-Landa, BA, University of California (Irvine), and medical writer for UroToday.com