47 THE METASTATIC POTENTIAL OF RETROPERITONEAL TUMORS: ANALYSIS AND COMPARISON OF RENAL CELL CARCINOMA (RCC), ADRENOCORTICAL CARCINOMA (ACC), AND RETROPERITONEAL SARCOMA (RPS) COHORTS FROM THE NATIONAL CANCER DATA BASE (NCDB) (2013)

You have accessJournal of UrologyAdrenal1 Apr 201347 THE METASTATIC POTENTIAL OF RETROPERITONEAL TUMORS: ANALYSIS AND COMPARISON OF RENAL CELL CARCINOMA (RCC), ADRENOCORTICAL CARCINOMA (ACC), AND RETROPERITONEAL SARCOMA (RPS) COHORTS FROM THE NATIONAL CANCER DATA BASE (NCDB) Daniel Canter, Katherine Mallin, Brian Egleston, Jay Simhan, Marc C. Smaldone, Robert J. Canter, Paul L. Crispen, Gennady Bratslavsky, Robert G Uzzo, and Alexander Kutikov Daniel CanterDaniel Canter Decatur, GA More articles by this author , Katherine MallinKatherine Mallin Chicago, IL More articles by this author , Brian EglestonBrian Egleston Philadelphia, PA More articles by this author , Jay SimhanJay Simhan Philadelpha, PA More articles by this author , Marc C. SmaldoneMarc C. Smaldone Philadelphia, PA More articles by this author , Robert J. CanterRobert J. Canter Sacramento, CA More articles by this author , Paul L. CrispenPaul L. Crispen Lexington, KY More articles by this author , Gennady BratslavskyGennady Bratslavsky Syracuse, NY More articles by this author , Robert G UzzoRobert G Uzzo Philadelphia, PA More articles by this author , and Alexander KutikovAlexander Kutikov Philadelphia, PA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1423AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Due to anatomic seclusion, retroperitoneal tumors can grow to very large sizes prior to diagnosis, thereby presenting a model for studying the relationship between tumor size and metastatic potential. Using a large dataset, we examined the relationship of presenting tumor size to rates of synchronous distant disease in patients with renal cell carcinoma (RCC), adrenocortical carcinoma (ACC), and retroperitoneal sarcoma (RPS). METHODS We queried the NCDB to identify all patients diagnosed with RCC and RPS (1993-2008) and ACC (1985-2000) for which tumor size/staging data were available. The relationship between tumor size and rates of non-localized (N+ and/or M+) disease was examined using a cubic spline analysis (Figure 1). Using Chi Square analysis and multivariate logistic regression (MVA), we compared rates of distant disease between T1 and T2 tumor size. RESULTS 231,923 RCC, 1,682 ACC, and 6,099 RPS patients were included in the analysis. Rates of non-localized disease were determined as a function of increasing tumor size per centimeter increase. In RCC patients, rates of non-localized disease at presentation rose in a linear fashion (OR = 1.15, p<0.001). Comparison of tumor size groups for ACC (OR = 1.02, p = 0.004) and RPS (OR = 0.98, p<0.001) revealed statistically significant yet likely clinically unimportant differences between tumor size groups and rates of distant disease. A multivariate analysis including gender, tumor size and grade, and year of diagnosis showed similar results for tumor size and distant disease. A higher rate of non-localized disease in T1 versus T2 tumors (9.9% versus 34.0%) was noted for patients with RCC (p<0.01). In contrast, rates of distant disease between T1 and T2 tumors (50.7% to 52.6%, p=0.59) for ACC and RPS (15.9% to 17.2%, p=0.48) revealed no significant differences. CONCLUSIONS Despite anatomic proximity, RCC, ACC, and RPS exhibit distinctly different rates of synchronous metastatic disease at a given tumor size. Furthermore, unlike renal malignancy, ACC and RPS exhibit only small variations in rates of distant disease with changing tumor size, including T1 and T2 tumor size cutoffs. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e19 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.Metrics Author Information Daniel Canter Decatur, GA More articles by this author Katherine Mallin Chicago, IL More articles by this author Brian Egleston Philadelphia, PA More articles by this author Jay Simhan Philadelpha, PA More articles by this author Marc C. Smaldone Philadelphia, PA More articles by this author Robert J. Canter Sacramento, CA More articles by this author Paul L. Crispen Lexington, KY More articles by this author Gennady Bratslavsky Syracuse, NY More articles by this author Robert G Uzzo Philadelphia, PA More articles by this author Alexander Kutikov Philadelphia, PA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...