MP61-08 TOWARDS PERSONALIZED CARE OF CT1A PAPILLARY RCC DIAGNOSED ON BIOPSY
Notice bibliographique
Résumé
You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging/Surveillance III (MP61)1 Sep 2021MP61-08 TOWARDS PERSONALIZED CARE OF CT1A PAPILLARY RCC DIAGNOSED ON BIOPSY Johan Björklund, Douglas C Cheung, Robert J Hamilton, John Kachura, Michael Jewett, Alexandre R Zlotta, and Antonio Finelli Johan BjörklundJohan Björklund More articles by this author , Douglas C CheungDouglas C Cheung More articles by this author , Robert J HamiltonRobert J Hamilton More articles by this author , John KachuraJohn Kachura More articles by this author , Michael JewettMichael Jewett More articles by this author , Alexandre R ZlottaAlexandre R Zlotta More articles by this author , and Antonio FinelliAntonio Finelli More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002101.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Papillary Renal Cell Carcinomas (pRCC) are divided histologically into type 1 (pRCC1) and type 2 (pRCC2), but there are histological subtypes of pRCC that are unclassifiable (pRCCX). The subtypes cannot be discerned on imaging, but are clinically relevant: pRCC2 is associated with more aggressive disease, where pRCC1 carries a relatively low risk of metastases. Our objective was to evaluate the clinical and pathologic outcomes for biopsy-proven pRCC small renal masses (SRM) within our institutional database. METHODS: All SRM with a first pRCC histology at renal biopsy were included between 1994 to 2020 at Princess Margaret Cancer Centre, Toronto, Canada. Patients were evaluated for treatment strategy, follow-up, intervention, and pathologic concordance on subsequent nephrectomy. The pRCC was divided into pRCC1, pRCC2 and pRCCX if no subtype was specified. Active surveillance (AS) was defined as not undergoing intervention within 1 year of biopsy diagnosis. RESULTS: 178 SRM with biopsy-proven pRCC were identified. On their first diagnostic biopsy, 116 (65%) were pRCC1, 19 (11%) were pRCC2, and 43 (24%) were pRCCX. 52 (29%) had at least one follow-up biopsy and the median follow-up time was 42 months (IQR 21-76). The primary management strategy was surgery in 66 (37%), RFA in 52 (29%), and AS in 60 (34%) patients. Median age at biopsy was 64 and median size of the SRM was 2.4 cm (IQR 1.8 – 3). 71 patients underwent surgery either primarily or after AS or RFA. 4 patients managed with AS went on to have Nephrectomy and 6 AS patients had a subsequent RFA. Of the 40 patients with pRCC1 on biopsy, 32 (80%) had a pRCC1 on surgical pathology, of the 10 with pRCC2 on biopsy 30% had pRCC2 on surgical pathology, and of the 21 patients with pRCCX on biopsy 6 29% had pRCCX on surgical pathology. A total of 7 (10%) patients has other RCC on SP, Table 1. CONCLUSIONS: A biopsy of pRCC1 was highly predictive for pRCC1 on surgical pathology with no patients reclassifying to the more aggressive pRCC2, while 2 (5%) reclassified to other RCC. A biopsy with pRCC1 was much more correlated to a similar outcome on surgical pathology than pRCC2 and pRCCX. Only 10 (16%) patients shifted strategy from AS to treatment indicating it a reasonable strategy for the patients managed with AS in this cohort. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1085-e1086 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Johan Björklund More articles by this author Douglas C Cheung More articles by this author Robert J Hamilton More articles by this author John Kachura More articles by this author Michael Jewett More articles by this author Alexandre R Zlotta More articles by this author Antonio Finelli More articles by this author Expand All Advertisement Loading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,011 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,001 | 0,003 |
| Intégrité de la recherche | 0,003 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,165 | 0,116 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».