Assessing AUA Surveillance Guidelines in Kidney Cancer

Following American Urological Association (AUA) guidelines may increase metastasis-free survival (MFS) in kidney cancer, according to a study presented at the 2022 International Kidney Cancer Symposium: North America.

In this study, Wesley Yip, MD, and colleagues assessed 3255 patients who underwent partial nephrectomy (PN) between January 2000 and March 2017. The investigators used Kaplan-Meier methods to estimate MFS, cancer-specific survival (CSS), and overall survival (OS), while multivariable Cox proportional hazard regression was used to estimate for each outcome.

According to the results, the before AUA guidelines (n=2289) and after AUA guidelines (N=966) study groups displayed similar tumor characteristics, with an average tumor size of 2.9 cm in both groups; tumor stage pT1 in 79% and 80%, respectively; and positive surgical margin rates of 5.8% and 5.1%, respectively. The researchers observed that almost 300 patients died from any cause, and 24 of those patients died from kidney cancer. Overall, the after AUA group demonstrated notably better MFS (hazard ratio [HR], 0.34; 95% CI, 0.13, 0.87; P=.024) and nonsignificantly better CSS (HR, 0.28; 95% CI, 0.06, 1.20; P=.086) and OS (HR, 0.75; 95% CI, 0.51, 1.12; P=.2).

“Detection of metastases following PN is a rare event, regardless of follow-up regimen. Adoption of the AUA guidelines may increase MFS but does not impact CSS or OS, which supports guideline adherence for risk-adapted follow-up of clinically localized renal neoplasms after PN,” the researchers concluded.

Source: Yip W, Tracey A, Nogueira L. Survival outcomes following adoption of risk-adjusted AUA surveillance guidelines after partial nephrectomy. Poster 15. Presented at the 2022 IKCS: North America; November 4-5, 2022; Austin, Texas.