PD59-01 BAP1 LOSS IS ASSOCIATED WITH METASTASIS IN ADVANCED CLEAR CELL RENAL CELL CARCINOMA

You have accessJournal of UrologyCME1 May 2022PD59-01 BAP1 LOSS IS ASSOCIATED WITH METASTASIS IN ADVANCED CLEAR CELL RENAL CELL CARCINOMA Sari Khaleel, Anne Reiner, Cameron Brennan, Ibrahim Hussain, Samuel Berman, Ari Hakimi, and Nelson Moss Sari KhaleelSari Khaleel More articles by this author , Anne ReinerAnne Reiner More articles by this author , Cameron BrennanCameron Brennan More articles by this author , Ibrahim HussainIbrahim Hussain More articles by this author , Samuel BermanSamuel Berman More articles by this author , Ari HakimiAri Hakimi More articles by this author , and Nelson MossNelson Moss More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002644.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Mutations of the BAP1 tumor suppressor gene are found in 10-15% of clear cell renal cell carcinoma (ccRCC), portending a poor prognosis relative to BAP1-wildtype (BAP1-WT) tumors. However, it remains unclear if BAP1 loss predicts metastatic phenotype in ccRCC. We sought to assess the cumulative incidence of metastases in patients with BAP1-mutant (BAP1-MT) vs BAP1-WT ccRCC tumors. METHODS: We performed a retrospective review of 96 patients diagnosed with ccRCC with known BAP1 mutation status, managed at a tertiary care cancer center between 10/2001-9/2016, comparing patients with BAP1-MT (47 patients) to BAP1-WT (49 patients) tumors. For each patient, we retrieved clinical features and all metastatic events (MEs), accounting for the organ compartment and date of each individual ME noted on imaging and/or pathology reports. We hypothesized that BAP1-MT was associated with a higher likelihood of cumulative MEs overall, as well as a specific metastatic phenotype, defined as a predilection for cumulative MEs in one of two major compartments – bone or soft tissue (all non-bony compartments). Categorical and continuous outcomes were compared by BAP1 mutational status using Fisher’s exact test and Welch T-test, respectively, while cumulative incidence of MEs was compared between BAP1-MT and BAP1-WT using subdistribution hazard ratio (SD-HR) analysis. Analyses were performed using R package (R Foundation, v4.1). RESULTS: Median patient age at diagnosis was 58 years, with 20 (20.8%) patients presenting with metastatic disease at the time of diagnosis. Most patients were males (62, 64.6%), and underwent nephrectomy (84, 87.5%). Median follow-up was 52 months [IQR 22.25 – 78.25 months]. BAP1-MT and BAP1-WT did not differ significantly by age or BMI (p > 0.05). BAP1-MT patients had a higher AJCC stage on nephrectomy (p < 0.0001), with higher overall cumulative MEs (SD-HR 2.1, 95% CI 1.0-4.5, p = 0.05). Specifically, we noted a high incidence of MEs in bone (SD-HR 5.5, p = 0.02, 95% CI 1.3-23.5) followed by soft tissue (SD-HR 2.7, p = 0.001, 95% CI 1.5 – 5.0) (Figure 1). CONCLUSIONS: Mutations of the BAP1 gene were associated with higher stage disease and incidence of metastases overall, with a higher cumulative incidence of metastases in bone compared to soft tissue compartments, suggesting a potential metastatic phenotype for this mutation. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e1018 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sari Khaleel More articles by this author Anne Reiner More articles by this author Cameron Brennan More articles by this author Ibrahim Hussain More articles by this author Samuel Berman More articles by this author Ari Hakimi More articles by this author Nelson Moss More articles by this author Expand All Advertisement PDF DownloadLoading ...