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

Atiqullah Aziz, Matthias May, Richard Zigeuner, Martin Pichler, Thomas Chromecki, Luca Cindolo, Luigi Schips, Ottavio De Cobelli, Bernardo Rocco, Cosimo De Nunzio, Andrea Tubaro, Ioan Coman, Michael Truss, Orietta Dalpiaz, Bernd Hoschke, Christian Gilfrich, Bogdan Feciche, Fabian Fenske, Petros Sountoulides, Robert S. FigenshauKerry Madison, Manuel Sánchez-Chapado, Maria Del Carmen Santiago Martin, Wolf F. Wieland, Luigi Salzano, Giuseppe Lotrecchiano, Raphaela Waidelich, Christian Stief, Sabine Brookman-May

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Purpose We analyzed the distinct clinicopathological features and prognosis of patients with renal cell carcinoma age 40 years or less compared to a reference group of patients 60 to 70 years old. Materials and Methods Overall 2,572 patients retrieved from a multicenter international database comprised of 6,234 patients with surgically treated renal cell carcinoma were included in this retrospective study. Clinical and histopathological features of 297 patients 40 years old or younger (4.8%) were compared to those of 2,275 patients (36.5%) 60 to 70 years old, who served as the reference group. Median followup was 59 months. The impact of young age and further parameters on disease specific mortality and all cause mortality was evaluated by multivariate Cox proportional hazards regression analyses. Results Young patients more frequently underwent nephron sparing surgery (27% vs 20%, p = 0.008) and regional lymph node dissection compared to older patients (38% vs 32%, p = 0.025). Organ confined tumor stage (81% vs 70%, p <0.001), smaller tumor diameter (4.5 vs 4.7 cm, p = 0.014) and chromophobe subtype (10% vs 4%, p <0.001) were significantly more frequent in young patients. On multivariate analysis older patients had a higher disease specific (HR 2.21, p <0.001) and all cause mortality (HR 3.05, p <0.001). The c indices for the Cox models were 0.87 and 0.78, respectively. However, integration of the variable age group did not significantly increase the predictive accuracy of the disease specific and all cause mortality models. Conclusions 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.

Original languageEnglish
Pages (from-to)310-315
Number of pages6
JournalJournal of Urology
Volume191
Issue number2
DOIs
StatePublished - Feb 1 2014

Keywords

  • age factors
  • carcinoma
  • neoplasms by histologic type
  • nephrectomy
  • outcome assessment
  • renal cell

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