AUA 2018: Distribution of M0 Renal Cell Carcinoma Metastases Stratified by Pathologic Nodal Status

San Francisco, CA USA (UroToday.com) David Y Yang, from the Mayo Clinic, Rochester, MN presented an evaluation of the timing and anatomic distribution of first metastasis in treated RCC patients stratified by nodal status. Yang began by identifying that brain metastases are frequently diagnosed among patients with renal cell carcinoma (RCC) and are associated with a poor prognosis. These patients have historically been excluded from clinical trials and aggressive treatment regimens. There are limited guidelines on screening and surveillance for brain involvement.

Therefore, they sought to evaluate their single institutional experience to determine factors associated with presentation and outcome. Site specific metastases-free survival rates were estimated using the Kaplan-Meier method, using the duration of follow-up calculated as date of nephrectomy to date of first distant metastases.

They identified patients who underwent nephrectomy and subsequently developed oligometastatic recurrence. They found that 940 patients were N0/x while 135 patients were N1. Median time to metastasis for those with node positive disease was certainly shorter, and the most common distant metastasis for both groups was the lungs. Yang concluded that N1 nodal status is associated with more frequent early metastasis to sites conferring poor prognosis, including bone and liver.

Presented by: David Y Yang

Written by: Kaelyn See, Department of Urology, University of California-Irvine at the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA

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