SIU 2017: Differences in Clinical and Pathological Characteristics Between Patients with Small Renal Masses (T1a) and Larger Renal Masses

Lisbon, Portugal ( The primary objective of this study was to assess clinical differences between patients presenting with a small renal mass (SRM) (cT1a) (<4 cm) and larger renal masses (>cT1b) (>4 cm). Additionally, small RCC masses specifically were compared to large RCC masses. 

Between Jan 2010 and Feb 2012 patients in the CROES renal mass registry cohort were included in this study. All included patients were with either cTla (n=1713) or  >cT1b (n=1819), Only patients who were NX/0 and M0 were included in the study. The RCC pTla and >pT1b cohorts consisted of 1194 and 1380 patients respectively. The 2009 TNM classification stage was used. Age, gender, ethnicity, BMI, comorbidities , risk factors, and history of RCC were compared between the two cohorts. 

Patients with a cT1a tumors were more commonly Caucasian (p=0.049), had more comorbidities (p=0.001), and a higher rate of risk factors (p=0.002). Median pre-operative Creatinine value was lower in the cTla cohort (p=0.032) and a higher number of patients had advanced CKD stage (>III) in the cT1b cohort (p=0.002). In the cT1a cohort the tumor was predominantly discovered as an incidental finding compared to >cT1b (83.8% vs. 62.1% p<0.001). A solitary kidney was more frequently encountered in the cTla cohort.. Out of the cT1a cases 13.9% were pathologically upstaged mostly to pT3a. Conversely 13.8% of >cT1b cases were pathologically downstaged to pT1a. 

When comparing between RCC pTla vs. pT1b and above, a significant difference in risk factors (p=0.014), advanced CKD (p=0.018), incidental finding (p<0.001), and solitary kidney (p=0.002) was demonstrated. Furthermore, a significant difference was observed between pT1a and >pT1b for mean age (60.0 vs. 61.7, p=0.001).

The authors concluded that differences between cT1a and >cT1b tumors were found for ethnicity, comorbidities, and pre-operative creatinine values. RCC patients in the pTla cohort were younger than in the >pT1b cohort.

Presented by: Bernhard JCl
Affiliation: Centre Hospitalier Universitaire de Bordeaux, Bordeaux, 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

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