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Urology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Urology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; VHL unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Urology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
VHL unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
VHL unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
VHL unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Urology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; VHL unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
hereditary renal cell carcinoma, genetic testing, early-onset renal cell carcinoma, VHL, age criteria in hereditary renal cell carcinoma
AbstractAlthough age younger than 46 years has been an independent criterion for genetic testing in hereditary renal cell carcinoma (hRCC), there is a lack of evidence in the literature. This study aims to analyze whether a 46-year-old cut-off should be considered an independent genetic testing criterion and to elucidate risk factors predicting a positive genetic test. Observational study from January 2010 to December 2021. All patients under 46 years with a non-metastatic kidney mass and surgical indication were included. We assume patients who relapse in the first 5 years of follow-up could have a positive genetic test. As risk factors for relapse, ergo positive genetic test, we consider those patients who presented multifocal, bilateral, or previous renal tumor. Of 2,232 nephrectomies for kidney cancer, 301 patients met the inclusion criteria. The median follow-up was 60 months (IQR 29-101). The estimated five-year RFS was 94.4% (95% CI 91.3-97.5). Tumor size, previous renal tumor, multifocality, bilaterality, and pT3 or pT4 stage were independent recurrence risk factors. Genetic testing was performed on 24 patients. Ten patients had pathogenic variants in the test, 8 of which recurred during their life. The 46-year-old cut-off has shown low performance in genetic testing. Therefore, we recommend that it be considered only if other hRCC risk criteria exist. Multifocality, bilaterality, and previous renal tumor could predict a positive genetic test.
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