Impact of Time to Surgery and Surgical Delay on Oncologic Outcomes for Renal Cell Carcinoma

No AccessJournal of UrologyAdult Urology1 Jan 2021Impact of Time to Surgery and Surgical Delay on Oncologic Outcomes for Renal Cell CarcinomaThis article is commented on by the following:Editorial CommentEditorial Comment Benjamin Shiff, Rodney H. Breau, Premal Patel, Ranjeeta Mallick, Simon Tanguay, Alan So, Luke Lavallée, Ron Moore, Ricardo Rendon, Anil Kapoor, Frédéric Pouliot, Antonio Finelli, Bimal Bhindi, Jean-Baptiste Lattouf, Naveen Basappa, Lori Wood, Daniel Heng, Georg Bjarnason, and Darrel Drachenberg Benjamin ShiffBenjamin Shiff Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada , Rodney H. BreauRodney H. Breau Division of Urology, University of Ottawa, Ottawa, Ontario, Canada , Premal PatelPremal Patel Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada , Ranjeeta MallickRanjeeta Mallick Ottawa Hospital Research Institute, Ottawa, Ontario, Canada , Simon TanguaySimon Tanguay Division of Urology, McGill University, Montreal, Quebec, Canada , Alan SoAlan So Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada , Luke LavalléeLuke Lavallée Division of Urology, University of Ottawa, Ottawa, Ontario, Canada , Ron MooreRon Moore Division of Urology, University of Alberta, Edmonton, Alberta, Canada , Ricardo RendonRicardo Rendon Department of Urology), Dalhousie University, Halifax, Nova Scotia, Canada , Anil KapoorAnil Kapoor Division of Urology, McMaster University, Hamilton, Ontario, Canada , Frédéric PouliotFrédéric Pouliot Division of Urology, Université Laval, Quebec City, Quebec, Canada , Antonio FinelliAntonio Finelli Division of Urology, University of Toronto, Toronto, Ontario, Canada , Bimal BhindiBimal Bhindi Section of Urology, University of Calgary, Calgary, Alberta, Canada , Jean-Baptiste LattoufJean-Baptiste Lattouf Section of Urology, Université de Montreal, Montreal, Quebec, Canada , Naveen BasappaNaveen Basappa Department of Oncology, University of Alberta, Edmonton, Alberta, Canada , Lori WoodLori Wood Division of Medical Oncology, Dalhousie University, Halifax, Nova Scotia, Canada , Daniel HengDaniel Heng Department of Oncology, University of Calgary, Calgary, Alberta, Canada , Georg BjarnasonGeorg Bjarnason Department of Oncology, University of Toronto, Toronto, Ontario, Canada , and Darrel DrachenbergDarrel Drachenberg †Correspondence: St. Boniface Hospital, Z3015-409 Tache Ave., Winnipeg, Manitoba , CanadaR2H 2A6 telephone: 204-237-2571; E-mail Address: [email protected] Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada View All Author Informationhttps://doi.org/10.1097/JU.0000000000001230AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail 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. References 1. United States Census Bureau: An Aging Nation: Projected Number of Children and Older Adults. United States Census Bureau. 2017. Available at https://www.census.gov/library/visualizations/2018/comm/historic-first.html. Accessed April 16, 2019. Google Scholar 2. : Wait times for cancer surgery in the United States: trends and predictors of delays. Ann Surg 2011; 253: 779. Google Scholar 3. : An interval longer than 12 weeks between the diagnosis of muscle invasion and cystectomy is associated with worse outcome in bladder carcinoma. J Urol 2003; 169: 110. 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Google Scholar © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited BySmith J (2020) This Month in Adult UrologyJournal of Urology, VOL. 205, NO. 1, (1-3), Online publication date: 1-Jan-2021.Related articlesJournal of UrologyNov 10, 2020, 12:00:00 AMEditorial CommentJournal of UrologyNov 10, 2020, 12:00:00 AMEditorial Comment Volume 205Issue 1January 2021Page: 78-85Supplementary Materials Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.Keywordsrenal cellsurvivaltime-to-treatmentcarcinomaMetricsAuthor Information Benjamin Shiff Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada Equal study contribution. More articles by this author Rodney H. Breau Division of Urology, University of Ottawa, Ottawa, Ontario, Canada Equal study contribution. More articles by this author Premal Patel Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada More articles by this author Ranjeeta Mallick Ottawa Hospital Research Institute, Ottawa, Ontario, Canada More articles by this author Simon Tanguay Division of Urology, McGill University, Montreal, Quebec, Canada More articles by this author Alan So Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada More articles by this author Luke Lavallée Division of Urology, University of Ottawa, Ottawa, Ontario, Canada More articles by this author Ron Moore Division of Urology, University of Alberta, Edmonton, Alberta, Canada More articles by this author Ricardo Rendon Department of Urology), Dalhousie University, Halifax, Nova Scotia, Canada More articles by this author Anil Kapoor Division of Urology, McMaster University, Hamilton, Ontario, Canada More articles by this author Frédéric Pouliot Division of Urology, Université Laval, Quebec City, Quebec, Canada More articles by this author Antonio Finelli Division of Urology, University of Toronto, Toronto, Ontario, Canada More articles by this author Bimal Bhindi Section of Urology, University of Calgary, Calgary, Alberta, Canada More articles by this author Jean-Baptiste Lattouf Section of Urology, Université de Montreal, Montreal, Quebec, Canada More articles by this author Naveen Basappa Department of Oncology, University of Alberta, Edmonton, Alberta, Canada More articles by this author Lori Wood Division of Medical Oncology, Dalhousie University, Halifax, Nova Scotia, Canada More articles by this author Daniel Heng Department of Oncology, University of Calgary, Calgary, Alberta, Canada More articles by this author Georg Bjarnason Department of Oncology, University of Toronto, Toronto, Ontario, Canada More articles by this author Darrel Drachenberg Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada †Correspondence: St. Boniface Hospital, Z3015-409 Tache Ave., Winnipeg, Manitoba , CanadaR2H 2A6 telephone: 204-237-2571; E-mail Address: [email protected] More articles by this author Expand All Advertisement PDF DownloadLoading ...