S.M. Turner3, D. Shapiro2, P. Chauhan1, K. Schadler1, P. Msaouel1, M. Swartz1 1University Of Texas MD Anderson Cancer Center, Pediatric And Genitourinary Departments, Houston, TX, USA 2University Of Wisconsin, Department Of Urology, Madison, WI, USA 3SUNY Upstate Medical University, Syracuse, NEW YORK, USA
Introduction:
Renal Medullary Carcinoma (RMC), a rare and aggressive subtype of Renal Carcinomas, is predominantly associated with Sickle Cell Trait (SCT), affecting around ninety percent of cases. It is characterized by a loss of SMARCB1. Currently, there are limited modifiable risk factors for RMC that have been identified for individuals with SCT. Recently, we found initial evidence that high-intensity physical activity is significantly associated with an elevated risk of RMC. This connection, based on our mouse model, stems from the inherent hypoxic and hypertonic nature of the renal medulla, exacerbated in individuals with SCT, leading to heightened blood cell sickling. Understanding this connection is imperative, because different levels of exercise can influence hypoxic conditions in skeletal muscle, cardiac muscle, and areas of the renal medulla. Identifying these parameters is key to decreasing an individual's risk of RMC. Thus, our aim is to determine the physical activity level among individuals diagnosed with RMC as compared to the published data.
Methods: A cross-sectional study will be performed. Patients are eligible if they are diagnosed with RMC, ES, MRT, SMARCB1-deficient sinonasal carcinoma, or any other SMARCB-1 deficient malignancies, as well as other variant genitourinary tract histologies such as CDC, poorly differentiated TCC, ALK-RCC, FH-RCC, HLRCC, TRCC, papillary renal cell carcinoma, chromophobe renal cell carcinoma, ccRCC, or unclassified renal cell carcinoma confirmed by pathology. Patients are asked to provide reported levels of physical activity using a 28-item surveysurvey. These questions are based on the 2013-2014 National Health and Nutrition Examination Surveys (NHANES) Physical Activity Questionnaire. Additional clinical and demographic variables will be extracted from EPIC. We will conduct descriptive analysis using SPSS and 2-sample z-test to compare the proportions of individuals with RMC reaching the 2018 aerobic physical activity guidelines compared to the published data.
Results: We had 30 completed surveys from individuals with RMC. Based on previous data, the median age is 35 years old. In terms of race/ethnicity breakdown, the majority are African American and Non-Hispanic. We also found that a greater proportion of individuals with RMC are reaching the 2013- 2014 aerobic physical activity guidelines compared to the published data.
Conclusion: Our findings indicate a greater proportion of individuals with RMC meet the aerobic physical activity guidelines compared to the published data which provides further evidence of the association between higher physical activity levels with RMC in individuals with the SCT. Such data further elucidates the association of physical activity level and RMC and pave the way for future studies to determine the safe exercise levels for individuals with SCT, especially those occupationally engaged in high-intensity exercise.