@Article{,
AUTHOR = {Jacob Grassauer, Wesley H. Chou, Anna Geduldig, Jackson Schmidt, Nicholas H. Chakiryan},
TITLE = {Clinical implications of tumor laterality in renal cell carcinoma},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {31},
YEAR = {2024},
NUMBER = {6},
PAGES = {12060--12071},
URL = {http://www.techscience.com/CJU/v31n6/59555},
ISSN = {1488-5581},
ABSTRACT = {<b>Introduction: </b>It is unclear whether laterality has
prognostic implications for patients with renal cell
carcinoma (RCC). Some suggest that left sided tumors
may have worse survival outcomes. The purpose of this
study is to associate tumor characteristics and clinical
outcomes with laterality in patients with RCC.<br/>
<b>Materials and methods:</b> Patients with RCC were
identified in the National Cancer Database between
2004-2020. Patients were categorized as having either
localized, regional or metastatic disease. Time-series
charts were generated to demonstrate laterality differences
and variance over time. Multivariable Cox proportional
hazards regression was utilized to associate laterality with
overall survival, stratified by clinical stage. Kaplan-Meier
estimates were utilized to visualize survival functions.<br/>
<b>Results:</b> A total of 306,196 patients were included, 156,450 (51.1%) had right sided tumors and 283,282
(92.5%) had localized RCC. Localized tumors were more
likely to be right sided (0.51 [95% CI
0.50-0.52], p < 0.001). Metastatic and regional tumors
(cN+M0) were more likely to be left sided (0.48 [0.47
0.49], p < 0.001; and 0.43 [0.41-0.45], p < 0.001;
respectively). For localized disease, smaller tumors were
more likely to be right sided (< 2 cm: 0.52 [0.51-0.52],
p < 0.001), while tumors > 7cm showed no significant site
association (0.49 [0.49-0.50], p = 0.07). When stratified
by staging, there were no significant associations between
laterality and OS (localized RCC: HR 1.01 [0.99-1.02],
p = 0.50; metastatic RCC: 1.03 [1.00-1.07], p = 0.7;
cN+M0 RCC: 0.96 [0.86-1.07], p = 0.50).<br/>
<b>Conclusions:</b> Left-sided RCC tumors are associated with
larger tumor size and a higher propensity for regional
nodal involvement and distant metastases. However, they
do not demonstrate more aggressive behavior leading to
meaningful survival differences.},
DOI = {}
}