MP22-17 THE METASTATIC POTENTIAL OF RENAL TUMORS: INFLUENCE OF HISTOLOGIC SUBTYPES ON DEFINITION OF SMALL RENAL MASSES, RISK STRATIFICATION, AND FUTURE ACTIVE SURVEILLANCE PROTOCOLS (2017)

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging I1 Apr 2017MP22-17 THE METASTATIC POTENTIAL OF RENAL TUMORS: INFLUENCE OF HISTOLOGIC SUBTYPES ON DEFINITION OF SMALL RENAL MASSES, RISK STRATIFICATION, AND FUTURE ACTIVE SURVEILLANCE PROTOCOLS Michael Daugherty, Dillon Sedaghatpour, Oleg Shapiro, Srinivas Vourganti, Alexander Kutikov, and Gennady Bratslavsky Michael DaughertyMichael Daugherty More articles by this author , Dillon SedaghatpourDillon Sedaghatpour More articles by this author , Oleg ShapiroOleg Shapiro More articles by this author , Srinivas VourgantiSrinivas Vourganti More articles by this author , Alexander KutikovAlexander Kutikov More articles by this author , and Gennady BratslavskyGennady Bratslavsky More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.671AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The influence of histology in metastatic potential is often overlooked when discussing the management options of small renal masses (SRM), with size or growth rate often serving as the triggers for the intervention. We aim to re-examine the definition of a SRM by evaluating the metastatic potential of renal masses incorporating tumor size and histology to create metastatic risk tables. METHODS SEER-18 registries database was queried for all cases of clear cell, papillary, and chromophobe RCC diagnosed between 2004 and 2012. There were 55,478 cases identified that included 43,783, 8,587, and 3,208 cases of clear cell, papillary and chromophobe, respectively. Tumors were stratified using 1 cm increments to determine the metastatic potential by calculating the metastatic rate at presentation for different size intervals in histologic categories. RESULTS For all three histologies, tumors 5 cm or less had a rate of metastatic RCC at presentation of less than 4%. The metastatic potential was highest for clear cell, followed by papillary and then chromophobe tumors. Setting a cutoff of no more than 3% for metastatic potential to be called a SRM, makes clear cell carcinoma and papillary carcinoma a SRM up to 4 cm, while the chromophobe RCC would be considered a SRM up to 7 cm. CONCLUSIONS While clinical staging and tumor size have been the key determinants in decision-making of patients with solid renal tumors, the histology-specific risks of metastatic potential are different for each mass. The definition of a SRM should be based on the metastatic potential and not on tumor size alone. This information could be helpful for counseling and managing patients with SRMs, as well as modifying active-surveillance protocols. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e263-e264 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Michael Daugherty More articles by this author Dillon Sedaghatpour More articles by this author Oleg Shapiro More articles by this author Srinivas Vourganti More articles by this author Alexander Kutikov More articles by this author Gennady Bratslavsky More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...