Novel Urinary Biomarker Offers Potential for RCC Detection, Surveillance

Approximately 82,000 new cases of renal cell carcinoma (RCC) are diagnosed each year in the United States, but effective methods for early detection of the disease are lacking.

Data on a novel urinary biomarker for RCC detection developed by Ethan Vargo, DO, and colleagues were presented at the 2024 American Urological Association Annual Meeting.

A group of 10 patients with cT1a-cT2N0M0 renal masses were involved in the study. Urine samples were collected from each patient prior to undergoing robotic partial (RPN) or robotic radical nephrectomy (RRN) and after surgery.

The urine samples were analyzed for tumor cell density, and patient characteristics such as gender, laterality, and presence of microhematuria were assessed. Each sample was collected at different times postoperatively and compared with preoperative levels. Samples underwent novel filtering and polymerase chain reaction testing to determine urinary tumor cell density (UTC/50 ml; UTCD).

Urine samples from 10 healthy nephrectomy patients were used as controls. Postoperative characteristics, including final pathology, histology, grade, presence of lymphovascular invasion, and margin status were examined.

The preoperative urinalysis tests were negative for microhematuria in 7 of 8 cases. RPN was carried out in 9 patients, with 1 undergoing RRN. Mean preoperative mass size was 3.8 cm (range, 1.9-8.8 cm).

Clear cell RCC was found in 7 patients, while 1 patient had papillary RCC, 1 patient had clear cell RCC with leiomyomatous features, and 1 patient had clear cell RCC and oncocytoma. All patients had negative surgical margins.

The mean preoperative UTCD in patients with renal tumors was 3.69. A significant decrease in mean postoperative UTCD to 1.94 (P=.01) was noted in 8 of 10 patients. An overall uptrend in UTCD occurred as tumor size increased, and the mean UTCD increased with higher tumor grades. The mean UTCD of the control group was significantly lower than that of patients with preoperative renal masses (P<.01).

This study demonstrates the potential of a novel urinary biomarker for the detection of RCC. Further research utilizing larger patient sample sizes is warranted.