PD46-01 IMPACT OF TIME-TO-SURGERY AND SURGICAL DELAY ON ONCOLOGIC OUTCOMES FOR RENAL CELL CARCINOMA

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You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy V (PD46)1 Apr 2019PD46-01 IMPACT OF TIME-TO-SURGERY AND SURGICAL DELAY ON ONCOLOGIC OUTCOMES FOR RENAL CELL CARCINOMA Benjamin Shiff*, Rodney Breau, Premal Patel, Anil Kapoor, Frederic Pouliot, Alan So, Ricardo Rendon, Ron Moore, Antonio Finelli, Simon Tanguay, Luke Lavallee, Jean-Baptiste Lattouf, Jun Kawakami, Daniel Heng, Ranjeeta Mallick, and Darrell Drachenberg Benjamin Shiff*Benjamin Shiff* More articles by this author , Rodney BreauRodney Breau More articles by this author , Premal PatelPremal Patel More articles by this author , Anil KapoorAnil Kapoor More articles by this author , Frederic PouliotFrederic Pouliot More articles by this author , Alan SoAlan So More articles by this author , Ricardo RendonRicardo Rendon More articles by this author , Ron MooreRon Moore More articles by this author , Antonio FinelliAntonio Finelli More articles by this author , Simon TanguaySimon Tanguay More articles by this author , Luke LavalleeLuke Lavallee More articles by this author , Jean-Baptiste LattoufJean-Baptiste Lattouf More articles by this author , Jun KawakamiJun Kawakami More articles by this author , Daniel HengDaniel Heng More articles by this author , Ranjeeta MallickRanjeeta Mallick More articles by this author , and Darrell DrachenbergDarrell Drachenberg More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556745.68596.55AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Surgical wait times (SWT) are a major concern in healthcare, with hospitals burdened by increased demand and limited resources. In 2005, the Canadian Surgical Wait Time Consensus statement suggested wait times of <90 days for T1a, and <28 days for >/=T1b asymptomatic renal masses. Few reports have examined the effect of prolonged SWT for renal cancer surgery on oncologic outcomes, and those that exist were conducted on a single institution level. We aimed to evaluate whether SWT is associated with treatment outcomes for renal masses on a multi-institution level. METHODS: The Canadian Kidney information system (CKCis) is a national multi-institution database of patients with kidney tumors. This database was used to identify a historical cohort of patients who underwent surgery for >/= clinical stage T1b renal cell carcinoma (RCC) from 2011 onwards. Time from final imaging prior to surgery to the date of surgery was used as a measure of SWT. Oncologic outcomes such as recurrence-free survival, cancer-specific survival, and overall survival were stratified by clinical stage and SWT to assess for associations between SWT and outcomes. RESULTS: Of 1,395 patients included in the analysis, 664 (47.6%) were categorized as stage cT1b, 387 (27.7%) as stage cT2, and 344 (24.7%) as stage cT3/4. Mean follow-up duration was 28.80 months. Mean SWT was 61.6 days, 39.3 days, and 31.5 days for stage cT1b, cT2, and cT3/4, respectively. Among cT1b, cT2, and cT3/4 patients, SWT exceeded 12 weeks in 27.4%, 11.6%, and 8.1% of patients, respectively. There was no association between SWT and recurrence-free survival, margin status, or lymph node status for tumors of all clinical stages. CONCLUSIONS: Mean SWTs for renal cancer surgery appear to be within recommendations, though a significant proportion of cT1b patients are experiencing prolonged wait times. Patients who had longer SWTs in this study did not experience negative oncologic outcomes such as positive margins, positive lymph nodes, or worse recurrence free survival among all clinical stages. Source of Funding: None Winnipeg, Canada; Ottawa, Canada; Miami, FL; Hamilton, Canada; Quebec City, Canada; Vancouver, Canada; Halifax, Canada; Edmonton, Canada; Toronto, Canada; Montreal, Canada; Calgary, Canada; Montreal, Canada; Calgary, Canada; Edmonton, Canada; Ottawa, Canada; Winnipeg, Canada© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e831-e832 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Benjamin Shiff* More articles by this author Rodney Breau More articles by this author Premal Patel More articles by this author Anil Kapoor More articles by this author Frederic Pouliot More articles by this author Alan So More articles by this author Ricardo Rendon More articles by this author Ron Moore More articles by this author Antonio Finelli More articles by this author Simon Tanguay More articles by this author Luke Lavallee More articles by this author Jean-Baptiste Lattouf More articles by this author Jun Kawakami More articles by this author Daniel Heng More articles by this author Ranjeeta Mallick More articles by this author Darrell Drachenberg More articles by this author Expand All Advertisement PDF downloadLoading ...

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