MP51-17 NATURAL HISTORY OF PATIENTS WITH REGIONAL LYMPH NODE POSITIVE RENAL CELL CARCINOMA: RESULTS FROM THE CANADIAN KIDNEY CANCER COLLABORATION
Bibliographic record
Abstract
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 ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".