All patients older than 18 years in the prospective international CROES Renal Mass registry were included in this study. Patients were selected according to the continent in which they were treated for their renal mass, with an overall 4,274 patients included in the study. The 2009 TNM classifications was used to assign clinical and pathologic stage. Treatment modalities and pathological characteristics were compared among continents.
Most patients were treated in Europe (3012), followed by the Americas (913) and Asia (349). Median age was lowest in Asia (57 [interquartile range (iqr):45.0-66.0]) compared to Europe and the Americas (63 (iqr: 54.0-71.0] and 62 [iqr: 53.0-71.0]). The male:female ratio was 1.8:1 for Europe and Asia, and 1.6:1 for the Americas. Median BMI and comorbidities were highest for the Americas (28.2 [iqr: 25.2-32.1], 74.6%) and lowest for Asia (23.8 [iqr: 21.6-26. 1], 47.4%). Hypertension was the most frequent comorbidity overall. The number of patients with multiple comorbidities was the highest in Europe and the Americas (27.3%). Risk factors for RCC and incidental finding were also highest for the Americas (48.2%, 77.4%). Smoking was the most common risk factor overall. Chronic kidney disease >III ranged from 21.5% in Europe to 25.0% in the Americas. Median clinical tumor size (mm) ranged from 35 mm (the Americas) to 54 mm (Asia). Clinical T1a ranged from 79.8% (Americas) to 62.9% (Asia). Active surveillance was most common in the Americas (10.8%) compared to Europe and Asia (1.7%). Radical nephrectomy was more frequently employed in Asia (61.6%), and nephron sparing surgery in the Americas (64.6%). Median pathological tumor size (mm) ranged from 40mm (the Americas) to 50 mm (Asia). The prevalence of pT1 tumors ranged from 74.8% in the Americas to 59.2% in Asia.
Although patients in the Americas exhibited higher BMI, percentage of comorbidities, risk factors, and CKD stage > III; Europe patients had higher tumor size and stage. The highest percentage of incidental tumor diagnosis was in America.
Presented by: Verhoest G
Affiliation: Rennes University Hospital, Rennes, France
Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre.Twitter: @GoldbergHanan at the 37th Congress of Société Internationale d’Urologie - October 19-22, 2017- Lisbon, Portugal