Benjamin Shiff1, Rodney H Breau2, Premal Patel1, Ranjeeta Mallick3, Simon Tanguay4, Alan So5, Luke Lavallée2, Ron Moore6, Ricardo Rendon7, Anil Kapoor8, Frédéric Pouliot9, Antonio Finelli10, Bimal Bhindi11, Jean-Baptiste Lattouf12, Naveen Basappa13, Lori Wood14, Daniel Heng15, Georg Bjarnason16, Darrel Drachenberg1. 1. Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada. 2. Division of Urology, University of Ottawa, Ottawa, Ontario, Canada. 3. Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. 4. Division of Urology, McGill University, Montreal, Quebec, Canada. 5. Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada. 6. Division of Urology, University of Alberta, Edmonton, Alberta, Canada. 7. Department of Urology), Dalhousie University, Halifax, Nova Scotia, Canada. 8. Division of Urology, McMaster University, Hamilton, Ontario, Canada. 9. Division of Urology, Université Laval, Quebec City, Quebec, Canada. 10. Division of Urology, University of Toronto, Toronto, Ontario, Canada. 11. Section of Urology, University of Calgary, Calgary, Alberta, Canada. 12. Section of Urology, Université de Montreal, Montreal, Quebec, Canada. 13. Department of Oncology, University of Alberta, Edmonton, Alberta, Canada. 14. Division of Medical Oncology, Dalhousie University, Halifax, Nova Scotia, Canada. 15. Department of Oncology, University of Calgary, Calgary, Alberta, Canada. 16. Department of Oncology, University of Toronto, Toronto, Ontario, Canada.
Abstract
PURPOSE: The time between radiographic identification of a renal tumor and surgery can be concerning for patients and clinicians due to fears of tumor progression while awaiting treatment. This study aimed to evaluate the association between surgical wait time and oncologic outcomes for patients with renal cell carcinoma. MATERIALS AND METHODS: The Canadian Kidney Cancer Information System is a multi-institutional prospective cohort initiated in January 2011. Patients with clinical stage T1b or greater renal cell carcinoma diagnosed between January 2011 and December 2019 were included in this analysis. Outcomes of interest were pathological up staging, cancer recurrence, cancer specific survival and overall survival. Time to recurrence and death were estimated using Kaplan-Meier estimates and associations were determined using Cox proportional hazards models. RESULTS: A total of 1,769 patients satisfied the study criteria. Median wait times were 54 days (IQR 29-86) for the overall cohort and 81 days (IQR 49-127) for cT1b tumors (1,166 patients), 45 days (IQR 27-71) for cT2 tumors (672 cases) and 35 days (IQR 18-61) for cT3/4 tumors (563). Adjusting for comorbidity, tumor size, grade, histological subtype, margin status and pathological stage, there was no association between prolonged wait time and cancer recurrence or death. CONCLUSIONS: In the context of current surgeon triaging practices surgical wait times up to 24 weeks were not associated with adverse oncologic outcomes after 2 years of followup.
PURPOSE: The time between radiographic identification of a renal tumor and surgery can be concerning for patients and clinicians due to fears of tumor progression while awaiting treatment. This study aimed to evaluate the association between surgical wait time and oncologic outcomes for patients with renal cell carcinoma. MATERIALS AND METHODS: The Canadian Kidney Cancer Information System is a multi-institutional prospective cohort initiated in January 2011. Patients with clinical stage T1b or greater renal cell carcinoma diagnosed between January 2011 and December 2019 were included in this analysis. Outcomes of interest were pathological up staging, cancer recurrence, cancer specific survival and overall survival. Time to recurrence and death were estimated using Kaplan-Meier estimates and associations were determined using Cox proportional hazards models. RESULTS: A total of 1,769 patients satisfied the study criteria. Median wait times were 54 days (IQR 29-86) for the overall cohort and 81 days (IQR 49-127) for cT1b tumors (1,166 patients), 45 days (IQR 27-71) for cT2tumors (672 cases) and 35 days (IQR 18-61) for cT3/4tumors (563). Adjusting for comorbidity, tumor size, grade, histological subtype, margin status and pathological stage, there was no association between prolonged wait time and cancer recurrence or death. CONCLUSIONS: In the context of current surgeon triaging practices surgical wait times up to 24 weeks were not associated with adverse oncologic outcomes after 2 years of followup.
Authors: Tina Felfeli; Raphael Ximenes; David M J Naimark; Philip L Hooper; Robert J Campbell; Sherif R El-Defrawy; Beate Sander Journal: CMAJ Open Date: 2021-11-23
Authors: Stephan Ursprung; Helen Mossop; Ferdia A Gallagher; Evis Sala; Richard Skells; Jamal A N Sipple; Thomas J Mitchell; Anita Chhabra; Kate Fife; Athena Matakidou; Gemma Young; Amanda Walker; Martin G Thomas; Mireia Crispin Ortuzar; Mark Sullivan; Andrew Protheroe; Grenville Oades; Balaji Venugopal; Anne Y Warren; John Stone; Tim Eisen; James Wason; Sarah J Welsh; Grant D Stewart Journal: BMC Cancer Date: 2021-11-18 Impact factor: 4.430
Authors: Arnav Srivastava; Hiren V Patel; Sinae Kim; Brian Shinder; Joshua Sterling; Alexandra L Tabakin; Charles F Polotti; Biren Saraiya; Tina Mayer; Isaac Y Kim; Saum Ghodoussipour; Hiten D Patel; Thomas L Jang; Eric A Singer Journal: Urol Oncol Date: 2020-10-20 Impact factor: 3.498
Authors: Wojciech Krajewski; Marco Moschini; Joanna Chorbińska; Łukasz Nowak; Sławomir Poletajew; Andrzej Tukiendorf; Luca Afferi; Jeremy Yuen-Chun Teoh; Tim Muilwijk; Steven Joniau; Alessandro Tafuri; Alessandro Antonelli; Francesco Cianflone; Andrea Mari; Ettore Di Trapani; Kees Hendricksen; Mario Alvarez-Maestro; Andrea Rodríguez-Serrano; Giuseppe Simone; Stefania Zamboni; Claudio Simeone; Maria Cristina Marconi; Riccardo Mastroianni; Guillaume Ploussard; Ekaterina Laukhtina; Karl Tully; Anna Kołodziej; Joanna Krajewska; Radosław Piszczek; Evanguelos Xylinas; Romuald Zdrojowy Journal: World J Urol Date: 2020-11-23 Impact factor: 4.226