Key clinical point: Patients with incidental pathologic T3a (pT3a) upstaging after partial nephrectomy (PN) have significantly reduced recurrence-free survival (RFS) and cancer-specific survival (CSS) when compared to patients whose disease isn't upstages from pT1a-b.

Major finding: Of 1955 patients who had partial nephrectomies, 95 had pT3a upstaging. In those patients with pT3a upstaging, 3- and 5-year RFS were 81% and 58%, compared to 86% and 75% in pT1a-b controls (P = .01). CSS at 3 and 5 years was 91% and 90% in pT3a disease and 100% and 97% in pT1a-b controls (P less than .01). All-cause mortality at 3 and 5 years were 82% and 71% in pT3a disease and 93% and 80% in pT1a-b controls (P = .04).

Study details: Retrospective chart review was completed at the University of Michigan and Moffitt Cancer Center to identify patients undergoing PN for clinical T1 masses between 1995 and 2015. Patients with pT3a disease were individually matched by clinicopathologic features with patients undergoing PN with pT1a-b disease in a 1:2 ratio. Primary endpoint was recurrence-free survival (RFS). Secondary endpoints were all-cause mortality, cancer-specific survival (CSS), and rates of local and distant recurrence.

Disclosures: The authors had no relevant financial disclosures.

Source: Russell C et al. Urology; July 2018, 95-100. https://doi.org/10.1016/j.urology.2018.04.002