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AUA 2017

AUA 2017: Additive Prognostic Impact of Elevated De Ritis Ratio and Renal Score for Prediction of Survival Outcomes in Renal Cell Carcinoma After Surgical Treatment

Boston, MA (UroToday.com) Single center retrospective analysis of 524 patients with a mean follow up of 35.8 months from 2003-2015. The purpose of the study was to create a prognostic index using RENAL score as a measure of complex tumor morphology and De Ritis ratio as an inflammatory marker in 5-year overall survival (OS) in renal cell carcinoma. Patients were stratified into 3 groups: 0 markers if patients had a RENAL score ≤8 and De Ritis ratio ≤1.5, 1 marker if patients had a RENAL score >8 or De Ritis ratio >1.5, and 2 markers if patients had a RENAL score >8 and De Ritis ratio >1.5. Comparing RENAL score groups of ≤8 and >8 there was a significant difference in 5-year OS, 82.5% and 62.3% (log rank p<0.001), respectively, and a cox-model hazard ratio of worsened OS (HR) of 1.948 (p<0.001). Similarly there was a significant difference between groups with De Ritis ratio ≤1.5 and >1.5 in 5-year OS, 77.2% and 30.3%, respectively, and a cox-model hazard ratio of worsened OS of 3.737 (p<0.001). Next, using Kaplan Meier curve to analyze 5-year OS in the composite score, patients with 0 markers had 82.5% OS (log rank p<0.001), 1 marker had 66.4% OS (log rank p <0.001) with a HR of 1.833 (p=0.011), 2 markers had 30.3% OS (log rank p<0.001) and a HR of 7.680 (p<0.001). This combination of a morphological score (RENAL) and an inflammatory marker (De Ritis ratio) was associated with worsened overall survival in renal cell carcinoma. These findings point towards the development and validation of a prognostic index to assist in risk stratification for RCC follow up protocols.

Presented By: Aaron Bloch, BS

Co-Authors: Zachary Hamilton MD, Aaron Bloch BS, Charles Field BS, Katherine Fero BS, Sean Berquist BS, Abd-elrahma, Daniel Han MD, Fang Wan MS, James Proudfoot PhD, Ithaar Derweesh MD

Written By: Zhamshid Okhunov for UroToday.com

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA