MP51-17 NATURAL HISTORY OF PATIENTS WITH REGIONAL LYMPH NODE POSITIVE RENAL CELL CARCINOMA: RESULTS FROM THE CANADIAN KIDNEY CANCER COLLABORATION
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Résumé
You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging/Surveillance II (MP51)1 May 2024MP51-17 NATURAL HISTORY OF PATIENTS WITH REGIONAL LYMPH NODE POSITIVE RENAL CELL CARCINOMA: RESULTS FROM THE CANADIAN KIDNEY CANCER COLLABORATION Jesse T. R. Spooner, Christopher Bitcon, Rodney Breau, Wood Lori, Simon Tanguay, Antonio Finelli, Lucas Dean, Miles Mannas, Jay Nayak, Luke, Lavallee, Jean-Baptiste Lattouf, Frédéric Pouliot, Lalani Aly-Khan, Daniel Heng, Naveen Basappa, Bimal Bhindi, and Ricardo Rendon Jesse T. R. SpoonerJesse T. R. Spooner , Christopher BitconChristopher Bitcon , Rodney BreauRodney Breau , Wood LoriWood Lori , Simon TanguaySimon Tanguay , Antonio FinelliAntonio Finelli , Lucas DeanLucas Dean , Miles MannasMiles Mannas , Jay NayakJay Nayak , LukeLuke , Lavallee Lavallee , Jean-Baptiste LattoufJean-Baptiste Lattouf , Frédéric PouliotFrédéric Pouliot , Lalani Aly-KhanLalani Aly-Khan , Daniel HengDaniel Heng , Naveen BasappaNaveen Basappa , Bimal BhindiBimal Bhindi , and Ricardo RendonRicardo Rendon View All Author Informationhttps://doi.org/10.1097/01.JU.0001009492.49624.4b.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The presence of lymph nodes (LN) in renal cell carcinoma (RCC) is a known poor prognostic factor. The natural history of pT(any)N1M0 renal cell carcinoma has been difficult to study due to low sample sizes. For instance, a large multi-institutional prospective trial (EORTC 30881) had only 4% pN1M0 patients in their analysis of patients undergoing radical nephrectomy with and without LN dissection. This study aims to analyze the natural history of patients with pN1M0 RCC using a multi-institutional Canadian cohort. METHODS: The Canadian Kidney Cancer information system (CKCis), a multi-institutional prospective cohort database, was used to identify patients with pT(any)N1M0 disease since January 2011. Patients underwent surgical resection (partial or radical nephrectomy) with or without formal retroperitoneal lymph node dissection (RPLND). Primary outcomes included overall survival (OS), cancer-specific survival (CSS), and recurrence free survival (RFS). RESULTS: A total of 10,641 non metastatic surgical RCC patients were found. In total, 113 patients had T(any)pN1M0 disease with clear cell, chromophobe, or papillary histology with a median follow-up of 3.1 years (IQR 1.2-6). Histology demonstrated clear cell, chromophobe, papillary and clear cell papillary RCC in 64.42%, 5.77%, 27.89%, and 1.92%, respectively. Mean (SD) age was 63 ( ±12) years and 69% (n=78) were male. Clinical nodal disease (cN1) was identified pre-operatively in 37 patients (35.58%). Pathologic stages T1/T2 were seen in 12 patients (10.71%), and 100 patients (89.29%) had pT3/T4 disease. Grade 3/4 RCC was observed in 94 patients (88.68%). Tumor necrosis of the primary lesion was seen in 78 patients (69.64%).Disease recurrence was identified in 76.99% (n=87) of patients with a median time to recurrence of 4.8 months (IQR 3.6-7.2). 49.4% had non-LN distant metastases, 20.7% had LN-only metastases, 18.4% had both local and distant non-LN metastases, and 11.5% had only local metastases. The median OS was 4.4 years (IQR 3.4-6.5 years) and the median CSS was 5.5 years (IQR 3.8-non-estimable). CONCLUSIONS: This study highlights the unfavourable natural history of patients with renal cell carcinoma pT(any)N1M0 in a contemporary Canadian cohort. The results are particularly important in the era of adjuvant and salvage use of immune checkpoint inhibitors and highlight the need to closely monitor these patients as their prognosis is poor with high rates of recurrence within the first year. Source of Funding: The Kidney Cancer Research Network of Canada (KCRNC); the Canadian Kidney Cancer Information System (CKCis) © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e849 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Jesse T. R. Spooner More articles by this author Christopher Bitcon More articles by this author Rodney Breau More articles by this author Wood Lori More articles by this author Simon Tanguay More articles by this author Antonio Finelli More articles by this author Lucas Dean More articles by this author Miles Mannas More articles by this author Jay Nayak More articles by this author Luke More articles by this author Lavallee More articles by this author Jean-Baptiste Lattouf More articles by this author Frédéric Pouliot More articles by this author Lalani Aly-Khan More articles by this author Daniel Heng More articles by this author Naveen Basappa More articles by this author Bimal Bhindi More articles by this author Ricardo Rendon More articles by this author Expand All Advertisement PDF downloadLoading ...
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 | 0,001 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,002 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
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 ».