Risk factors for metachronous bilateral renal cell carcinoma: A Surveillance, Epidemiology, and End Results analysis

Abstract

Background Patients treated for renal cell carcinoma (RCC) may be diagnosed with a metachronous, contralateral tumor. We evaluated the risks of contralateral tumor development using the Surveillance, Epidemiology, and End Results database. Methods Among RCC patients, we identified those with a metachronous, contralateral RCC diagnosed ≥1 year after primary diagnosis. We performed a competing risks analysis to evaluate associations between clinicopathologic factors and metachronous, bilateral RCC. Cumulative incidence and standardized incidence ratios (SIRs) were calculated. Results There were 80,403 cases of RCC identified, with a median follow‐up of 8.3 years; of these, 1063 (1.3%) developed metachronous, contralateral RCC (median of 6 years after diagnosis). The cumulative incidence at 10, 20, and 30 years of follow‐up was 1.5%, 3.1%, and 4.7%, respectively. An increased risk was observed among men (hazard ratio [HR], 1.36; 95% confidence interval [CI], 1.20‐1.55), blacks (HR, 2.00; 95% CI, 1.71‐2.33), and those with papillary histology (HR, 1.72; 95% CI, 1.41‐2.10). Risk of metachronous disease decreased with increasing age at primary diagnosis (HR per 1‐year increase, 0.97; 95% CI, 0.96‐0.97). The SIRs were highest among those diagnosed at a younger age and remained elevated even after extended follow‐up (>10 years). Conclusions Our findings suggest that the cumulative incidence of metachronous, contralateral RCC may be higher than previously reported. Younger age, black race, papillary histology, and male sex increase the risk of metachronous, contralateral RCC development. The high SIRs seen in all demographic groups may support a rationale for lifelong surveillance, especially in high‐risk subgroups with early disease onset.

Incidence, risk and survival outcomes of second primary malignancy among renal cell carcinoma survivors: A nested case-control study

“…However, when considering contralateral kidney tumors, it is evident that the elderly patients do not have an increased risk. Our univariate analysis found that the risk of patients over 60 years-of-age was lower for contralateral kidney SPM than that of patients under 44 years-of-age; this was consistent with previous literature [20,21]. Age itself is an independent risk factor for cancer [22], and because the risk of developing tumors increases with age.…”

Risk of Second Primary Malignancies in Colon Cancer Patients Treated With Colectomy

“…Older age may lead to immunosenescence in these survivors ( 21 ), increasing the second cancer disease ( 22 , 23 ). Interestingly, like the results of previous studies in other tumors ( 24 , 25 ), black race increases the risk of SPMs in male CC survivors, especially for a second primary prostate carcinoma ( 3 ). We unexpectedly found higher risk to develop a SPM for married male CC patients, probably resulting from the impact of marital status on the occurrence of prostate carcinoma, and similar results showed that older, separated or divorced men existed a decreased risk for the development of prostate cancer ( 26 ), which is not easily explained.…”

Single-Cell RNA-seq Identification of the Cellular Molecular Characteristics of Sporadic Bilateral Clear Cell Renal Cell Carcinoma

“…A case of sporadic bilateral ccRCC was studied by single-cell transcriptome sequencing. Compared with many previous works on bilateral RCC (33)(34)(35) the present study firstly examined the tumour cellular biological characteristics of bilateral ccRCC at the single-cell level. Although large samples of DNA, bulk RNA and DNA methylation in ccRCC have been reported (29,30) these results only revealed the characteristics of RCC from an average level; specifying these attributes to cell types, especially tumour cells, is difficult.…”