Taylor Goodstein, MD, highlights project on staging in larger kidney tumors

In this video, Taylor Goodstein, MD, highlights an ongoing research project on the rates of upstaging and downstaging in larger kidney tumors. Goodstein is an SUO fellow at Emory Urology in Atlanta, Georgia.

Video Transcript:

There's a study I'm working on right now. I'm actually working with one of my colleagues back at Ohio State. I started on this project when I was still there, with Dr. Eric Singer as the PI. What we're looking at is the upstaging of kidney tumors. The reason why we started asking that question [is that] kidney tumor upstaging has always been reported for smaller stage 1 tumors, because it might change your management from partial to radical nephrectomy, but there hasn't really been a need to know what the upstaging is between these larger tumors to more invasive tumors. Except for now we've got these perioperative trials that are happening, like the PROSPER-RCC trial (NCT03055013), which looked at giving a dose of nivolumab prior to doing a nephrectomy and then following with another short course of nivolumab. Ultimately, it was a negative study, but it required them to actually clinically stage patients for inclusion in that trial. When it came out as a negative study, there was a lot of questions. Why was it a negative study?

One of the big concerns was did we choose the right cohort of patients? These were clinically staged patients. How accurate was that clinical staging? If you look at the table of that trial, there was a significant amount of upstaging and even some downstaging that happened from their clinical to pathological stage. What we've been working on is a giant 30,000 patient database study using the National Cancer Database to see exactly what the rates are of upstaging and downstaging for these larger kidney tumors, and then taking that a step further and trying to see if there's a survival difference if the patient was upstaged or downstaged or not. So, I don't think anybody's really looked too much at that before. I'd say that's something that we're doing that's pretty novel.

This transcript was AI generated and edited by human editors for clarity.