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Renal Cell Carcinoma and COVID-19: Does Surgical Delay Impact Outcomes?

By: Vanessa A. Carter, BS
Posted: Friday, January 8, 2021

The novel coronavirus (COVID-19) has negatively affected the efficiency of the health-care system. Arnav Srivastava, MD, MPH, of Rutgers Cancer Institute of New Jersey, and colleagues observed that a significant number of curative urologic oncology procedures had been postponed as a result. At the 2020 Annual Meeting of the International Kidney Cancer Symposium (IKCS; Abstract NAS105), these researchers reported that surgical delays did not seem to affect overall survival in some patients with localized renal cell carcinoma.

The risk of pT3a upstaging in patients with cT1b to cT2b renal cell carcinoma was assessed in 29,746 individuals from the National Cancer Database. A total of 22,719, 4,670, and 2,357 participants had cT1b, cT2a, and cT2b masses, respectively. Patients who underwent ablation, had no surgical intervention, or had no staging or histology data were not included in this study.

Surgical delay cohorts were split into three groups: less than 1 month, 1 to 3 months, and more than 3 months. After 120 months, the less-than-1-month group had overall survival rates of 65.4%, 74.5%, and 74.3% for the cT1b, cT2a, and cT2b groups, respectively; the 1-to-3-month group had rates of 54.0%, 71.6%, and 64.2%, respectively. In the more-than-3 months group, the overall survival rates for cT1b (41.8%), cT2a (65.0%), and cT2b (69.5%) groups were a bit lower on average. Upstaging rates at each point in time remained relatively similar throughout all disease stages, the investigators noted.

Although delaying surgery for more than 3 months showed no correlation to an increase in pT3a upstaging, patients with cT1b renal cell carcinoma were affected the most. Patients with these masses should be monitored carefully, as they may have a lower overall survival rate, suggested Dr. Srivastava and colleagues. 

Disclosure: The study authors reported no conflicts of interest.

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