Predictive characteristics for disease recurrence and overall survival in non-metastatic clinical T1 renal cell carcinoma – results from the National Swedish Kidney Cancer Register

Almdalal, Tarik; Rosenblad, Andreas; Hellström, Mikael; Kjellman, Anders; Lindblad, Per; Lundstam, Sven; Sundqvist, Pernilla; Ljungberg, Börje

doi:10.1080/21681805.2022.2154383

Cited by 8 publications

(6 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this study, we report the proportion of patients with metastatic disease at presentation among different RCC subtypes across varying primary tumor sizes. Our results are consistent with prior studies based on nephrectomy registries establishing the aggressive natures of specific subtypes and the indolent nature of others [9] , [10] , [15] , [16] . We supplement this prior work with the use of SEER cancer registry data to include patients who may never have been considered for nephrectomy.…”

Section: Discussionsupporting

confidence: 92%

The Metastatic Risk of Renal Cell Carcinoma by Primary Tumor Size and Subtype

Monda

Lui

Pratsinis

et al. 2023

European Urology Open Science

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 92%

The Metastatic Risk of Renal Cell Carcinoma by Primary Tumor Size and Subtype

Monda

Lui

Pratsinis

et al. 2023

European Urology Open Science

View full text Add to dashboard Cite

“…In a multicenter analysis comparing partial versus RN for complex renal masses, tumor size was significantly associated to survival and complications, while type of surgery was not [20]. Tumor size further associated with disease recurrence and OS in a real-world register-based analysis of patients with T1 RCC [5]. Our results confirm an independent importance of tumor size in the surgical treatment decision for all patients as well as for patients in the T1a subgroup.…”

Section: Discussionsupporting

confidence: 60%

“…However, it is still unclear whether PN provides an OS benefit in patients with a normal contralateral kidney, but PN is currently recommended as the reference standard for most localized renal masses [1]. In a real-world register study, the advantage of PN over RN for OS was verified [5]. In the present study, we also found that renal function had a univariate association to surgical treatment decision, but surprisingly, renal function lost its significant association after adjusted analysis.…”

Section: Discussionsupporting

confidence: 53%

“…Compared to the RN group, the PN group had a significantly longer median OS and CSS [14]. Retrospective studies of cT1 and cT2 patients upstaged to pT3a RCC show contradictory results, one study reports similar oncologic outcomes between PN and RN [15], while another suggests that PN of clinical T1 when pathologically upstaged to pT3a was associated with a significantly shorter recurrence-free survival than RN [5,16]. For patients with clinical T3-T4 RCC, RN remains the backbone of surgery [1].…”

Section: Discussionmentioning

confidence: 99%

“…In some series, this held true only for younger patients and/or patients without significant comorbidity at the time of the surgical intervention [4]. Although a prematurely closed randomized study comparing PN with RN found no survival benefit with nephron sparing treatment, real-world register data suggest that nephron sparing is of advantage for patients OS [5]. This finding might also be true for patients with T2 RCCs [6].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Multiple factors influence decision making for the surgical treatment in patients with renal cell carcinoma

Kröger Dahlin,

Hlodan,

Ghaffarpour

et al. 2024

SJU

Self Cite

View full text Add to dashboard Cite

Background: Surgical strategy in renal cell carcinoma (RCC) is considered based on the renal function. Partial nephrectomy (PN) preserves kidney function better than radical nephrectomy (RN), lowering risk of chronic kidney disease (CKD). The aim was to evaluate whether renal function and other clinical variables were important for surgical treatment selection. Methods: Patients with RCC, surgically treated between 1994 and 2018 were included. There were 663 patients in all stages, 265 women and 398 men, mean age 66 years. Clinical data: estimated glomerular filtration rate (eGFR), WHO performance status (WHO-PS), Charlson comorbidity index (CCI), surgery, T-stage, M-stage, RCC type, tumor size, age, and gender were extracted from the medical records. Statistical analysis included Mann-Whitney U, X2-test, and logistic regression analysis. Results: Of 663 patients, 455 were treated with RN and 208 with PN. In all patients, preoperative eGFR was significantly higher in PN (80.8) than in RN (77.1, p = 0.015). Using logistic regression tumor size (odds ratio [OR]: 0.96; 95% confidence interval [CI]: 0.95–0.98, T-stage (OR: 0.46; 95% CI: 0.33–0.65), WHO-PS (OR: 0.39; 95% CI: 0.04–0.57), and CCI (OR: 1.23; 95% CI: 1.05–1.44), associated to treatment selection, while eGFR, M-stage, age, and gender did not. In cTa subgroup, eGFR was also higher in PN (84.6) than in RN (75.0, p = 0.007). Using logistic regression, tumor size (OR: 0.93; 95% CI: 0.83–0.98) and WHO-PS (OR: 0.36; 95% CI: 0.20–0.66) associated to treatment selection, while eGFR, CCI, age, and gender did not. Conclusion: Tumor size, CCI scores, T-stage, and WHO-PS, all had an impact on the surgical strategy for all RCC patients. In patients with T1a RCC, tumor size and WHO-PS associated independently with treatment decision. After adjusted analysis, renal function lost its independent association with the treatment strategy in RCC patients.

show abstract

Recurrences after nephron-sparing treatments of renal cell carcinoma: a competing risk analysis

Rosenblad,

Hashim,

Lindblad

et al. 2024

World J Urol

View full text Add to dashboard Cite

Purpose To examine associations between ablative therapy (AT) and partial nephrectomy (PN) and the occurrence of local recurrence (LR), distant metastatic recurrence (DMR) and all-cause mortality in a nation-wide real-world population-based cohort of patients with nonmetastatic renal cell carcinoma (nmRCC). Methods Data on 2751 AT- or PN-treated nmRCC tumours diagnosed during 2005–2018, representing 2701 unique patients, were obtained from the National Swedish Kidney Cancer Register. Time to LR/DMR or death with/without LR/DMR was analysed using Cox regression models. Results During a mean of 4.8 years follow-up, LR was observed for 111 (4.0%) tumours, DMR for 108 (3.9%) tumours, and death without LR/DMR for 206 (7.5%) tumours. AT-treated tumours had a 4.31 times higher risk of LR (P < 0.001) and a 1.91 times higher risk of DMR (P = 0.018) than PN-treated, with no significant differences in risk of death without LR/DMR. During a mean of 3.2 and 2.5 years of follow-up after LR/DMR, respectively, 24 (21.6%) of the LR cases and 56 (51.9%) of the DMR cases died, compared to 7.5% in patients without LR/DMR. There were no significant differences between AT- and PN-treated regarding risks of early death after occurrence of LR or DMR. Conclusion AT treatment of patients with nmRCC implied significantly higher risks of LR and DMR compared with PN treatment. To minimize the risks of LR and DMR, these results suggest that PN is preferred over AT as primary treatment, supporting the EAU guidelines to recommended AT mainly to frail and/or comorbid patients.

show abstract

Predictive characteristics for disease recurrence and overall survival in non-metastatic clinical T1 renal cell carcinoma – results from the National Swedish Kidney Cancer Register

Cited by 8 publications

References 33 publications

The Metastatic Risk of Renal Cell Carcinoma by Primary Tumor Size and Subtype

The Metastatic Risk of Renal Cell Carcinoma by Primary Tumor Size and Subtype

Multiple factors influence decision making for the surgical treatment in patients with renal cell carcinoma

Recurrences after nephron-sparing treatments of renal cell carcinoma: a competing risk analysis

Contact Info

Product

Resources

About