Do Young Patients with Renal Cell Carcinoma Feature a Distinct Outcome after Surgery? A Comparative Analysis of Patient Age Based on the Multinational CORONA Database

Aziz, Atiqullah; May, Matthias; Zigeuner, Richard; Pichler, Martin; Chromecki, Thomas; Cindolo, Luca; Schips, Luigi; Cobelli, Ottavio De; Rocco, Bernardo; Nunzio, Cosimo De; Tubaro, Andrea; Coman, Ioan; Truß, Michael C.; Dalpiaz, Orietta; Hoschke, B.; Gilfrich, Christian; Feciche, Bogdan; Fenske, Fabian; Sountoulides, Petros; Figenshau, R. Sherburne; Madison, Kerry; Sánchez‐Chapado, Manuel; Martin, Maria del Carmen Santiago; Wieland, Wolf F.; Salzano, L.; Lotrecchiano, Giuseppe; Waidelich, Raphaela; Stief, Christian G.; Brookman‐May, Sabine

doi:10.1016/j.juro.2013.08.021

Cited by 23 publications

(24 citation statements)

References 25 publications

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“…The aim of PN is not only the preservation of kidney function but also to avoid overtreatment for benign kidney tumours suspected of being cancerous, or for preserving treatment options in case of a tumour on the contralateral kidney. There is a report suggesting that patients who were aged ≤40 years more frequently underwent PN than patients aged 60–70 years . We also recommend PN over RN for young patients when technically feasible.…”

Section: Discussionmentioning

confidence: 90%

Comparison of survival rates in stage 1 renal cell carcinoma between partial nephrectomy and radical nephrectomy patients according to age distribution: a propensity score matching study

et al. 2015

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ObjectiveTo assess differences in overall survival (OS) between patients receiving partial nephrectomy (PN) and radical nephrectomy (RN) for stage 1 renal cell carcinoma (RCC) according to age distribution, as the survival advantage of PN vs RN has been unclear owing to conflicting data. Patients and MethodsWe studied 952 patients with stage 1 RCC who underwent either PN or RN. Patients were divided into three groups according to age: Group 1 (≤54 years), Group 2 (55-64 years), and Group 3 (≥65 years). Patient variables including age, body mass index, sex, presence of hypertension (HT) and/or diabetes mellitus (DM), performance status, tumour size, pathological diagnosis, nuclear grade, and preoperative estimated glomerular filtration rate (eGFR), were adjusted using 1:1 propensity score matching between PN and RN. ResultsGroup 1 included 66 matched patients; Group 2, 72; and Group 3, 70. Group 1 tended to have higher preoperative eGFR values and lower rates of HT and DM compared with Groups 2 and 3. Postoperative eGFR dropped by 11-13% in PN patients and by 34-36% in RN patients. In Group 3, PN patients had longer OS than RN patients (5-year OS: PN 96%, RN 81%, P = 0.043); however, there was no significant difference in Group 1 (5-year OS: PN 100%, RN 93%, P = 0.302) or Group 2 (5-year OS: PN 94%, RN 87%, P = 0.358). ConclusionsOnly the oldest group of patients showed significantly better OS for PN compared with RN; however, we still recommend PN in young patients.

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Section: Discussionmentioning

confidence: 90%

Comparison of survival rates in stage 1 renal cell carcinoma between partial nephrectomy and radical nephrectomy patients according to age distribution: a propensity score matching study

et al. 2015

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“…). The number of studies included for each specific aim are as follows: PA1/PA2: nine reports representing eight unique studies []; SA1: six studies (of which two represented separate analyses of the same dataset) ; SA2: 15 studies (of which one single‐institutional study was included in a multi‐institutional study) ; SA3: five studies ; SA4: 10 studies ; and SA5: 18 studies .…”

Section: Resultsmentioning

confidence: 99%

“…Two studies examined cohorts that included both M0 and M1 RCC (Tables and ) . In one of these, LND was not associated with survival in the overall cohort .…”

Section: Resultsmentioning

confidence: 99%

“…Two studies examined cohorts that included both M0 and M1 RCC (Tables and ) . In one of these, LND was not associated with survival in the overall cohort . In the other such study, LND was not associated with survival among patients without radiographic lymphadenopathy (cN1), but the authors did report an OS benefit among cN1 patients, although statistical adjustment was limited .…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies were included in the meta‐analysis (Fig. ) . The overall pooled HR was 1.00 (95% CI 0.92–1.09; I 2 = 0%), with no statistically significant differences by M stage subgroup ( P = 0.50).…”

Section: Resultsmentioning

confidence: 99%

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The role of lymph node dissection in the management of renal cell carcinoma: a systematic review and meta‐analysis

et al. 2018

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Our objective was to evaluate the role of retroperitoneal lymph node dissection (LND) in non-metastatic (M0) and metastatic (M1) renal cell carcinoma (RCC). We searched Medline, EMBASE, Web of Science and Scopus from database inception to 29 August 2017 for studies of patients who underwent partial or radical nephrectomy for M0 or M1 RCC. Two investigators independently selected studies for inclusion. Risk of bias was assessed using the Newcastle-Ottawa scale, Cochrane Collaboration tool and National Heart, Lung and Blood Institute Quality Assessment Tool. Random effects meta-analysis was performed for all-cause-mortality. The GRADE approach was used to characterize quality of evidence. A total of 51 unique studies were included in the qualitative systematic review. Risk of bias was low in 41/51 (80%) studies. LND was not associated with all-cause mortality in either M0 (hazard ratio [HR] 1.02, 95% confidence interval [CI] 0.92-1.12; I = 0%; four studies), M1 (HR 1.04, 95% CI 0.83-1.29; I = 0%; two studies), or pooled M0 and M1 settings (HR 1.00, 95% CI 0.92-1.09; I = 0%; seven studies), with no statistically significant differences according to M stage subgroups (P = 0.50). In the three studies that examined M0 subgroups with a high risk of nodal metastasis, LND was not associated with improved oncological outcomes. Studies on the association of extent of LND with survival reported inconsistent results. Meanwhile, a small proportion of patients with pN1M0 disease demonstrate durable long-term oncological control after surgery, with 10-year cancer-specific survival of 21-31%. Nodal involvement is independently associated with adverse prognosis in both M0 and M1 settings. GRADE quality of evidence was moderate or low for the outcomes examined. Although LND yields independent prognostic information, the existing literature does not support a therapeutic benefit to LND in either M0 or M1 RCC. High-risk M0 patient groups warrant further study, as a subset of patients with isolated nodal metastases experience long-term survival after surgical resection.

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Prognostic significance of Fuhrman grade and age for cancer-specific and overall survival in patients with papillary renal cell carcinoma: results of an international multi-institutional study on 2189 patients

Borgmann¹,

Musquera

Haferkamp³

et al. 2017

World J Urol

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Do Young Patients with Renal Cell Carcinoma Feature a Distinct Outcome after Surgery? A Comparative Analysis of Patient Age Based on the Multinational CORONA Database

Abstract: Young patients with renal cell carcinoma (40 years old or younger) have significantly different frequencies of clinical and histopathological features, and a significantly lower all cause and disease specific mortality compared to patients 60 to 70 years old.

Cited by 23 publications

References 25 publications

Comparison of survival rates in stage 1 renal cell carcinoma between partial nephrectomy and radical nephrectomy patients according to age distribution: a propensity score matching study

Comparison of survival rates in stage 1 renal cell carcinoma between partial nephrectomy and radical nephrectomy patients according to age distribution: a propensity score matching study

The role of lymph node dissection in the management of renal cell carcinoma: a systematic review and meta‐analysis

Prognostic significance of Fuhrman grade and age for cancer-specific and overall survival in patients with papillary renal cell carcinoma: results of an international multi-institutional study on 2189 patients

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