SAN DIEGO, CA USA (UroToday.com) - There is a paucity of literature that compares various retroperitoneal tumors and their behavior.
At this year’s “Adrenal” podium session, Dr. Daniel Canter from Emory University, working with investigators from Fox Chase Cancer Center, presented a study assessing rates of synchronous distant disease in patients with retroperitoneal sarcomas, renal cell, and adrenal carcinomas.
They identified patients by querying the NCDB and abstracting available pathologic and staging data. The relationship between tumor size and advanced disease (nodal involvement or distant metastasis) was then assessed in univariable and multivariable analysis in 231 923 renal cell carcinomas, 1 682 adrenocortical carcinomas, and 6 099 retroperitoneal sarcomas. The authors identified statistically significant relationships between advanced disease and tumor size in all three cancer types: RCC OR=1.15, p < 0.001), ACC (OR=1.02, p=0.004) and RPS (OR=0.98, p < 0.001), although the clinical significance of this association is likely low in ACC and RPS. Multivariable analysis included gender, tumor size, grade, and year of diagnosis, and demonstrated a similar relationship between tumor size and distant disease. When using tumor stage (T1 vs. T2) instead of size, presence of distant disease differed significantly in RCC tumors (9.9% vs. 34.0%, p < 0.01), but not for ACC (50.7% to 52.6%, p=0.59) or RPS (15.9% to 17.2%, p=0.48) tumors.
The authors conclude that retroperitoneal tumors demonstrate different rates of synchronous metastatic disease, where RCC metastases are size and stage dependent, while ACC and RPS are less so. This further supports a theory that some tumors (ACC, RPS) are born bad, while others (RCC) grow bad.
Presented by Daniel Canter, Katherine Mallin, Brian Egleston, Jay Simhan, Marc C Smaldone, Robert J Canter, Paul L Crispen, Gennady Bratslavsky, Robert G Uzzo, and Alexander Kutikov at the American Urological Association (AUA) Annual Meeting - May 4 - 8, 2013 - San Diego Convention Center - San Diego, California USA
Reported for UroToday.com by Serge Ginzburg, MD