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IMP3 positivity predicts metastatic-free survival in a contemporary cohort of patients with renal cell cancer
Scott Greenberg, MD; Alexander Miller, BA; Zhong Jiang, MD; Kristine Cornejo, MD; Tong Sun, MD; Mitchell Sokoloff, MD; Jennifer K. Yates, MD.
University of Massachusetts, Worcester, MA, USA.

BACKGROUND: Prognostic markers in renal cell cancer (RCC) can be clinically useful to risk stratify patients in regards to both overall and cancer specific survival. IMP3 staining has been shown to correlate with adverse outcomes in patients diagnosed with renal cell cancer. In this study, we sought to validate IMP3 staining as a predictor of development of metastatic disease in a contemporary cohort of patients treated surgically for RCC.METHODS: After obtaining IRB approval, pathology records were reviewed at our institution to identify patients undergoing either partial or radical nephrectomy between November 2008 and September 2014. A total of 302 patients were included in the study. The medical records of these patients were retrospectively reviewed to identify pertinent variables, including gender, age, medical comorbidities, treatment modality, imaging results before and after treatment (i.e. staging and surveillance), RCC subtype and Fuhrman grade, and IMP3 staining. Multivariate analysis was utilized to assess whether IMP3 positivity correlated with development of metastatic disease and overall survival.RESULTS: A total of 302 patients were included in the study, including 30% female and 70% male patients. Of the 302 renal masses (302 patients), 60 (19.9%) stained positive for IMP3, while 242 (80.1%) stained negative for IMP3. On multivariate analysis, IMP3 staining correlated with metastatic-free survival (p=0.014), but did not correlate with overall survival.CONCLUSIONS: Assessing a patient’s risk for developing metastatic disease after treatment for renal cell cancer has potential implications for patient counseling and surveillance protocols. In addition, as targeted agents are being evaluated for use in the adjuvant setting, risk stratification of patients would help identify those patients who may benefit most from adjuvant therapy. In this study, IMP3 staining predicted the development of metastatic disease. Overall survival was not related to IMP3 staining, but this may be related to duration of follow-up. Further evaluation of this cohort of patients will include long-term cancer specific survival and overall survival, as well as identification of other factors that may correlate with IMP3 positivity.


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