Vol. 191, No. 4S, Supplement, Sunday, May 18, 2014 THE JOURNAL OF UROLOGY� e385

BHD. BMO is readily diagnosed with kidney biopsy and can be safelymanaged by active surveillance.

Source of Funding:: This research was supported by theIntramural Research Program of the National Institutes of Health(NIH), National Cancer Institute, Center for Cancer Research

MP36-16EFFECTS OF DIABETES ON RENAL CANCER PROGNOSIS

Alper Otunctemur, Murat Dursun, Suleyman Sahin, Huseyin Besiroglu,Ismail Koklu, Mustafa Erkoc, Eyyup Danis, Muammer Bozkurt,Emin Ozbek*, Istanbul, Turkey

INTRODUCTION AND OBJECTIVES: Diabetes is a chronicdisease characterized by impaired fasting blood glucose that leads todisturbances in various organs. In this study, we evaluate the relation-ship between tumor size and grade with diabetes in patients with renalcell carcinoma.

METHODS: Between 2007-2013, 310 patients underwentradical nephrectomy for renal tumors and pathology reported renal cellcarcinoma enrolled in the study. Fasting glucose levels and HbA1clevels compared with tumor size and Fuhrman grade in patients withand without a history of diabetes. The results were statisticallyanalyzed.

RESULTS: Diabetes was found in 98 patients. The mean age ofthe patients with and without diabetes mellitus, respectively 64.3 (40-79) and 58.4 (31-87) years. In diabetes group we determined over 7 cmtumor size in 51% of patients and over fuhrman grade 3 tumor grade in53% of patients. In non-diabetes group we determined over 7 cm tumorsize in 38% of patients and over fuhrman grade 3 tumor grade in 28% ofpatients. The patients with diabetes compared to the patients withoutdiabetes, tumor size and grade were detected significantly higher(p<0,05) in diabetes goup.

CONCLUSIONS: Renal cancer remains more aggressive inpatients with diabetes. In this study lifestyle and risk factors with dia-betes regulation observed important for renal cancer patients. Multi-center studies are needed in larger series for more accurate results.

Source of Funding: none

MP36-17STATIN USE FOR DYSLIPIDEMIA IS ASSOCIATED WITHIMPROVED ONCOLOGIC OUTCOMES OF SURGICALLY TREATEDRENAL CELL CARCINOMA

Hak Lee*, La Jolla, CA; Aditya Bargrodia, Memphis, TN; Song Wang,Nishant Patel, Michael Liss, La Jolla, CA; Reza Mehrazin,Anthony Patterson, Jim Wan, Memphis, TN; Ithaar Derweesh,La Jolla, CA

INTRODUCTION AND OBJECTIVES: Use of statins hasrecently been suggested to be associated with improved cancer specificsurvival in RCC. We evaluated the role of statins in post-surgicalRCC patients.

METHODS: Multi-center retrospective study of RCC patientsunderwent surgery (either Radical or Partial Nephrectomy) from7/1987�11/2007. Within this cohort, we selected patients who eitherpre-operatively had dyslipidemia or post-operatively developed dyslipi-demia. Our primary outcome was progression free survival (PFS) andour secondary outcomes were cancer specific survival (CSS) andoverall survival (OS). Patient demographic and clinical characteristicswere analyzed between patients who received statin therapy versusthose that did not. Kaplan-Meier analysis estimated the PFS, OS andCSS by comparing statin or no statin groups with log-rank test. Multi-variable analysis (MVA) was performed to identify risk factors associ-ated with primary and secondary outcomes.

RESULTS: A total of 155 patients who had dyslipidemia wereanalyzed for PFS and 44 (28.3%) patients progressed in their disease.

Of the patients that progressed, 22 (14.1%) had died of their cancer. Atotal 92 (59.3%) patients were on statins. Median follow-up time was 68(IQR: 50-90) months. Univariable analysis comparing patients whowere on statins vs. no statins, demonstrated that there were no differ-ences in clinical or demographic variables (age, gender, ethnicity,smoking, ASA, diabetes, hypertension, pre and post-operative dyslipi-demia, pre and post-operative eGFR, tumor stage and size). Kaplan-Meier analysis (Figure) demonstrated a higher PFS in patients on sta-tins vs. no statins with 5-yr survival of 91% and 70%, respectively(p¼<0.001). In MVA, controlling for other variables, statin use wasindependently associated with improved PFS (OR 5.89; 95% CI 2.73-12.68; p¼<0.0001) and improved CSS (OR 3.15; 95% CI 1.40-7.07;p¼0.006), but not for OS (p¼0.22).

CONCLUSIONS: In a cohort of RCC patients with hyperlipid-emia, statin use was associated with improved PFS and CSS. Furtherinvestigations are required to determine the mechanism and utility ofstatins, and its potential benefits in a broader cohort of patients with RCC.

Source of Funding: none

MP36-18INCIDENCE OF HYBRID TUMORS FOUND IN EXCISED RENALMASSES: A MULTI-INSTITUTIONAL ANALYSIS

David Fumo*, Samay Jain, Toledo, OH; Ravi Munver, Hackensack, NJ

INTRODUCTION AND OBJECTIVES: The use of renal biopsyhas gained popularity as an adjunct in the work up of renal masses,particularly masses <4cm suspicious for renal cell carcinoma (RCC).Our present study attempts to quantify the prevalence of tumors thatcontain more than one histology as a means of determining the potentialaccuracy of renal biopsy.

METHODS: In this IRB approved, multi-institutional study, aretrospective review of renal masses removed for RCC between the yearsof 1998-2012 was performed. Patients and masses were included in thestudy if information pertaining to demographics and pathologic stage,mass size, and histology were present. Tumors were considered to behybrid if more than one distinct histology was reported in the final pathol-ogy. Granular cell RCC was considered a variant of clear cell RCC and,therefore, these masses were considered non-hybrid tumors. Statisticalanalyses were completed with paired T-tests and Chi Squared analysis,where appropriate. All analyses were completed using Microsoft Excel.

RESULTS: A total of 427 tumors were included in the analysis,summarized in Table1. Of the entire cohort, 48 tumors (11%) displayedmore than one distinct histology. The differences in mass size, T stageand age of patients between the two sub-groupswere not statisticallysignificant.

A majority of the hybrid tumors were pT1a and were a combinationof clear cell and papillary cell RCC. Twenty three of the hybrid tumorswere smaller than 4cm in size. Of all of the hybrid tumors, sevenshowed a combination of a malignant and benign histology, 4 of whichwere less than 4cm in size.