Exploring the Diversity and Predictors of Histopathological Findings Across the European Association of Urology Guidelines Office Rapid Reaction Group Priority Groups for Patients with Renal Tumors: Implications for Individualized Prioritization of Renal Cancer Care

被引:4
作者
Campi, Riccardo [1 ,2 ]
Tellini, Riccardo [1 ,3 ]
Grosso, Antonio Andrea [1 ,3 ]
Pecoraro, Alessio [1 ,3 ]
Mari, Andrea [2 ,3 ]
Raspollini, Maria Rosaria [4 ]
Gacci, Mauro [1 ]
Carini, Marco [2 ,3 ]
Serni, Sergio [1 ,2 ]
Minervini, Andrea [2 ,3 ]
机构
[1] Univ Florence, Careggi Hosp, Unit Urol Robot Surg & Renal Transplantat, Florence, Italy
[2] Univ Florence, Dept Expt & Clin Med, Florence, Italy
[3] Univ Florence, Careggi Hosp, Unit Urol Oncol Minimally Invas Robot Surg & Andr, Florence, Italy
[4] Azienda Osped Univ Careggi, Histopathol & Mol Diagnost, Florence, Italy
来源
EUROPEAN UROLOGY OPEN SCIENCE | 2021年 / 34卷
关键词
COVID-19; Histology; Nephrectomy; Prioritization; Renal cancer; CELL CARCINOMA; SURGERY;
D O I
10.1016/j.euros.2021.09.009
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
In response to the COVID-19 pandemic, the European Association of Urology (EAU) Guidelines Office Rapid Reaction Group (GORRG) defined priority groups to guide the prioritization of surgery for nonmetastatic renal cell carcinoma (RCC). In this study we explored the diversity and predictors of histopathological findings across the EAU GORRG priority groups using a large database of 1734 consecutive patients undergoing elective surgery for nonmetastatic renal masses between 2017 and 2020 at a referral institution. Overall, 940 (54.2%), 358 (20.6%), and 436 (25.2%) patients were classified as low-, intermediate-, and high-priority, respectively. The low-, intermediate-, and high-risk groups significantly differed regarding all primary histopathological outcomes: benign histology (21.6% vs 15.9% vs 6.4%; p < 0.001); non-organ-confined disease (5.0% vs 19.0% vs 45.4%; p < 0.001); and adverse pathological features according to validated prognostic models (including the median Leibovich score for clear-cell RCC: 0 vs 2 vs 4; p < 0.001). On multivariable analysis, beyond the EAU GORRG priority groups, specific patient and/or tumor-related characteristics were independent predictors of the afore-mentioned histopathological outcomes. To the best of our knowledge, our study shows for the first time the value of the EAU GORRG priority groups from a histopathological standpoint and supports implementation of such a prioritization scheme beyond the COVID-19 pandemic. Patient summary: During the COVID-19 pandemic, the European Association of Urology designed a scheme to prioritize patients needing surgery for kidney cancer according to their tumor characteristics and symptoms. We used results from our hospital database to test the scheme and found that the priority classification can be used to predict cancer outcomes after surgery. This scheme may be useful in prioritizing kidney cancer surg-eries after the COVID-19 pandemic. (c) 2021 The Author(s). Published by Elsevier B.V. on behalf of European Association of Urology. This is an open access article under the CC BY-NC-ND license (http://creative-commons.org/licenses/by-nc-nd/4.0/).
引用
收藏
页码:5 / 9
页数:5
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