The time between radiographic identification of a renal tumor and surgery can be concerning for patients and clinicians due to fears of tumor progression while awaiting treatment. This study aimed to evaluate the association between surgical wait time and oncologic outcomes for patients with renal cell carcinoma (RCC).
The Canadian Kidney Cancer information system (CKCis) is a multi-institutional prospective cohort initiated in January 2011. Patients with clinical stage T1b or greater RCC diagnosed between January 2011 to December 2019 were included in this analysis. Outcomes of interest were pathologic upstaging, cancer recurrence, cancer-specific survival, and overall survival. Time to recurrence and death were estimated using Kaplan-Meier estimates and associations were determined using cox-proportional hazards models.
1,769 patients satisfied the study criteria. Median wait times were 54 days (IQR 29-86) for the overall cohort and 81 days (IQR 49-127) for cT1b tumors (n=1166), 45 days (IQR 27-71) for cT2 tumors (n=672), and 35 days (IQR 18-61) for cT3/4 tumors (n=563 tumors). Adjusting for comorbidity, tumor size, grade, histologic subtype, margin status, and pathologic stage, there was no association between prolonged wait time and cancer recurrence or death.
In the context of current surgeon triaging practices, surgical wait times up to 24 weeks were not associated with adverse oncologic outcomes after 2 years of follow-up.
The Journal of urology. 2020 Jul 02 [Epub ahead of print]
Benjamin Shiff, Rodney H Breau, Premal Patel, Ranjeeta Mallick, Simon Tanguay, Alan So, Luke Lavallée, Ron Moore, Ricardo Rendon, Anil Kapoor, Frédéric Pouliot, Antonio Finelli, Bimal Bhindi, Jean-Baptiste Lattouf, Naveen Basappa, Lori Wood, Daniel Heng, Georg Bjarnason, Darrel Drachenberg
Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada., Division of Urology, University of Ottawa, Ottawa, Ontario, Canada., Ottawa Hospital Research Institute, Ottawa, Ontario, Canada., Division of Urology, McGill University, Montreal, Quebec, Canada., Department of Urologic Sciences, University of British Columbia, British Columbia, Canada., Division of Urology, University of Alberta, Edmonton, Alberta, Canada., Department of Urology, Dalhousie University, Halifax, Nova Scotia, Canada., Division of Urology, McMaster University, Hamilton, Ontario, Canada., Division of Urology, Université Laval, Quebec City, Quebec, Canada., Division of Urology, University of Toronto, Toronto, Ontario, Canada., Section of Urology, University of Calgary, Calgary, Alberta, Canada., Section of Urology, Université de Montreal, Montreal, Quebec, Canada., Department of Oncology, University of Alberta, Edmonton, Alberta, Canada., Division of Medical Oncology, Dalhousie University, Halifax, Nova Scotia, Canada., Department of Oncology, University of Calgary, Calgary, Alberta, Canada., Department of Oncology, University of Toronto, Toronto, Ontario, Canada.