ORLANDO, FL USA (UroToday.com) - Stage T4 RCC is defined as extension of tumor beyond Gerota’s fascia and/or invading into the adrenal gland. Patients with higher stage and advanced disease tend to have poor outcomes. Dae Y. Kim stated that patient counseling and surgical intervention is essential for patients with higher-risk disease. Therefore, their objective in this study was to determine variables that can predict survival in patients with T4 RCC.
The authors identified 67 patients with T4 disease. Both clinical and pathological variables were assessed in each patient, and they analyzed survival using Kaplan-Meier method.
They found that median survival was 18 months longer for patients who had lymph node dissection. After analysis, they found that predictors of survival were M stage at time of surgery, lymph node status and dissection, and histology of the tumor including sarcomatoid features in the tumor.
The authors concluded that median survival increases tremendously with lymph node dissection. Furthermore, they found that there are multiple variables that can potentially predict outcomes of patients with T4 disease. These findings are significant, and the authors concluded that having knowledge of predictors for each particular patient may assist in the informed decision-making process with regards to disease management. Surgeon preference may be related to the decision of lymph node dissection. Thus, this may introduce a bias with patient selection.
Presented by Dae Y. Kim at the American Urological Association (AUA) Annual Meeting- May 16 - 21, 2014 - Orlando, Florida USA
Houston, TX USA
Written by Garen Abedi, MD, University of California (Irvine), and medical writer for UroToday.com