Presentation Authors: Benjamin Shiff*, Winnipeg, Canada, Rodney Breau, Ottawa, Canada, Premal Patel, Miami, FL, Anil Kapoor, Hamilton, Canada, Frederic Pouliot, Quebec City, Canada, Alan So, Vancouver, Canada, Ricardo Rendon, Halifax, Canada, Ron Moore, Edmonton, Canada, Antonio Finelli, Toronto, Canada, Simon Tanguay, Montreal, Canada, Luke Lavallee, Calgary, Canada, Jean-Baptiste Lattouf, Montreal, Canada, Jun Kawakami, Calgary, Canada, Daniel Heng, Edmonton, Canada, Ranjeeta Mallick, Ottawa, Canada, Darrell Drachenberg, Winnipeg, Canada
Introduction: Surgical wait times (SWT) are a major concern in healthcare, with hospitals burdened by increased demand and limited resources. In 2005, the Canadian Surgical Wait Time Consensus statement suggested wait times of < 90 days for T1a, and < 28 days for >/=T1b asymptomatic renal masses. Few reports have examined the effect of prolonged SWT for renal cancer surgery on oncologic outcomes, and those that exist were conducted on a single institution level. We aimed to evaluate whether SWT is associated with treatment outcomes for renal masses on a multi-institution level.
Methods: The Canadian Kidney information system (CKCis) is a national multi-institution database of patients with kidney tumors. This database was used to identify a historical cohort of patients who underwent surgery for >/= clinical stage T1b renal cell carcinoma (RCC) from 2011 onwards. Time from final imaging prior to surgery to the date of surgery was used as a measure of SWT. Oncologic outcomes such as recurrence-free survival, cancer-specific survival, and overall survival were stratified by clinical stage and SWT to assess for associations between SWT and outcomes.
Results: Of 1,395 patients included in the analysis, 664 (47.6%) were categorized as stage cT1b, 387 (27.7%) as stage cT2, and 344 (24.7%) as stage cT3/4. Mean follow-up duration was 28.80 months. Mean SWT was 61.6 days, 39.3 days, and 31.5 days for stage cT1b, cT2, and cT3/4, respectively. Among cT1b, cT2, and cT3/4 patients, SWT exceeded 12 weeks in 27.4%, 11.6%, and 8.1% of patients, respectively. There was no association between SWT and recurrence-free survival, margin status, or lymph node status for tumors of all clinical stages.
Conclusions: Mean SWTs for renal cancer surgery appear to be within recommendations, though a significant proportion of cT1b patients are experiencing prolonged wait times. Patients who had longer SWTs in this study did not experience negative oncologic outcomes such as positive margins, positive lymph nodes, or worse recurrence free survival among all clinical stages.