title: Mayo Adhesive Probability Score Is Associated With Localized Renal Cell Carcinoma Progression-free Survival.
abstract: OBJECTIVE
  To assess the association of the Mayo Adhesive Probability (MAP) score and progression-free survival (PFS) in patients with renal cell carcinoma (RCC). The MAP score is derived from cross-sectional imaging measurements of perinephric fat thickness and stranding.
  
  
  METHODS
  We identified 456 patients from a prospective registry who were treated surgically for localized RCC between 2002 and 2014. One reviewer calculated a preoperative MAP score (0-5) for each patient. Kaplan-Meier curves were utilized to estimate PFS. Cox proportional hazard models were used to estimate the association of MAP score with risk of progression univariately and after adjusting for covariates such as age, body mass index (BMI), and size, stage, grade, necrosis scores.
  
  
  RESULTS
  Patients with higher MAP scores (4-5) were more likely to be male, to be older, to have higher BMI, and to have larger tumors (all P <.01). Of our total cohort, 405 patients had MAP scores and follow-up data to assess PFS. Dichotomizing MAP scores into high (MAP 4-5) and low (MAP 0-3) yields a hazard ratio of 2.16 for the 4-5 group vs 0-3 (95% confidence interval: 1.15-4.06, P = .017). Adjustment for BMI did not alter the association (BMI-adjusted hazard ratio [HR] = 2.20 [1.07-4.52], P = .032). Of interest, the association with MAP and PFS remains for pT1 RCC patients (n = 287, HR = 3.46 [1.06-11.24], P = .039).
  
  
  CONCLUSIONS
  High MAP scores (4-5) are associated with decreased PFS in patients surgically treated for clinically localized RCC compared with patients with lower MAP scores (0-3). RCC aggressiveness may be associated with perinephric fat thickness and stranding.
authors.affiliation: Department of Urology, Mayo Clinic, Jacksonville, FL. Electronic address: Thiel.David@mayo.edu.
authors.forename: David D
authors.initials: DD
authors.lastname: Thiel
authors.affiliation: Department of Urology, Mayo Clinic, Jacksonville, FL.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Davidiuk
authors.affiliation: Department of Urology, Mayo Clinic, Jacksonville, FL.
authors.forename: Camille
authors.initials: C
authors.lastname: Meschia
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL.
authors.forename: Daniel
authors.initials: D
authors.lastname: Serie
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL.
authors.forename: Kaitlynn
authors.initials: K
authors.lastname: Custer
authors.affiliation: Department of Urology, Mayo Clinic, Jacksonville, FL.
authors.forename: Steven P
authors.initials: SP
authors.lastname: Petrou
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL.
authors.forename: Alexander S
authors.initials: AS
authors.lastname: Parker
mesh_terms: D000273:Adipose Tissue / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult