Association Between the Sarcomatoid Status and Percentage of Sarcomatoid on the Clinical Outcomes of Localized Renal Cell Carcinoma Post Nephrectomy

Speaker(s)

Dragomir A1, Hesswani C1, Pouliot F2, Kapoor A3, Lavallée L4, Finelli A5, Rendon R6, Bhindi B7, Lattouf JB8, Lalani AK3, Heng DYC7, Bjarnason GA9, Breau RH4, Basappa NS10, Wood L6, Tanguay S11
1McGill University, Montreal, QC, Canada, 2Centre Hospitalier Universitaire de Québec, Quebec, QC, Canada, 3Juravinski Hospital and Saint-Joseph’s Healthcare Hamilton, Hamilton, ON, Canada, 4The Ottawa Hospital, Ottawa, ON, Canada, 5University Health Network, Toronto, ON, Canada, 6Capital Health Queen Elizabeth II Hospital, Halifax, NS, Canada, 7Alberta Health Services, Calgary, AB, Canada, 8Centre Hospitalier de l’Université de Montréal, Montréal, QC, Canada, 9Sunnybrook Health Sciences Centre, Toronto, ON, Canada, 10Alberta Health Services, Edmonton, AB, Canada, 11McGill University Health Centre, Montreal, QC, Canada

Presentation Documents

OBJECTIVES: The objectives of this study were to use real-world data to evaluate and compare the outcomes of localized RCC patients with and without a sarcomatoid component and the impact the percentage of sarcomatoid component has on cancer recurrence.

METHODS: The Canadian Kidney Cancer information system was used to identify patients diagnosed with localized RCC between January 2011 and April 2022. Only patients with a pT1-T3 stage and documented sarcomatoid status were included. Patients were first classified in two groups according to the sarcomatoid status. Patients with sarcomatoid RCC were then subclassified according to the sarcomatoid percentage (≤10% vs >10%). Inverse probability of treatment weighting using propensity scores was used to balance the groups for sex, age, Charlson comorbidity score, clear cell carcinoma, pathological stage and grade and size of the tumour. Cox proportional hazards models were used to assess the impact of sarcomatoid status and sarcomatoid percentage on recurrence free survival (RFS) and overall survival (OS).

RESULTS: A total of 170 sarcomatoid and 5,812 non-sarcomatoid RCC patients were included in the study cohort. The median sarcomatoid percentage was 10%. 52 patients had a sarcomatoid percentage above the median and 84 below or equal to the median. The weighted analysis revealed that the sarcomatoid status was associated with an increased risk of developing metastasis and of mortality compared to non-sarcomatoid patients ((RFS: HR 2.35, 95% CI 1.74-3.17) and (OS: HR 2.69, 95%CI 1.90-3.81)). A sarcomatoid involvement of >10% was associated with an increased risk of developing metastasis and of mortality compared to≤10% ((RFS: HR 1.84, 95%CI 1.13-3.01) and (OS: HR 1.92, 95%CI 1.02-3.60)).

CONCLUSIONS: Our study comprises one of the largest cohorts of patients with localized sRCC in the literature to date. We found that patients with sarcomatoid status or a sarcomatoid percentage >10% have an increased risk of recurrence and mortality.

Code

CO177

Topic

Clinical Outcomes

Topic Subcategory

Clinical Outcomes Assessment

Disease

SDC: Urinary/Kidney Disorders