Age at diagnosis is a determinant factor of renal cell carcinoma– specific survival in patients treated with nephrectomy

Authors

  • Pierre I. Karakiewicz Cancer Prognostics and Health Outcomes Unit; and Department of Urology, University of Montréal Health Centre, Montréal, Que.
  • Claudio Jeldres Cancer Prognostics and Health Outcomes Unit; and Department of Urology, University of Montréal Health Centre, Montréal, Que.
  • Nazareno Suardi Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Centre, Montréal, Que.
  • George C. Hutterer Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Centre; and the Department of Urology, Graz Medical University, Graz, Austria
  • Paul Perrotte Department of Urology, University of Montréal, Montréal, Que.
  • Umberto Capitanio Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Centre, Montréal, Que.
  • Vincenzo Ficarra Department of Urology, University of Padova, Padova, Italy
  • Luca Cindolo Department of Urology, S. Pio da Pietrelcina Hospital, Vasto, Italy
  • Alexandre de La Taille Department of Urology, Henri Mondor University Hospital, Creteil, France
  • Jacques Tostain Department of Urology, St. Etienne University Hospital, St. Etienne, France
  • Peter F. Mulders Department of Urology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
  • Laurent Salomon Department of Urology, Henri Mondor University Hospital, Creteil, France
  • Richard Zigeuner Department of Urology, Graz Medical University, Graz, Austria
  • Luigi Schips Department of Urology, Graz Medical University, Graz, Austria
  • Denis Chautard Department of Urology, Angers University Hospital, Angers, France
  • Antoine Valeri Comité de Cancérologie de l´Association Française d’Urologie (CCAFU), Rennes, France
  • Eric Lechevallier Comité de Cancérologie de l´Association Française d’Urologie (CCAFU), Rennes, France
  • Jean-Luc Descots Comité de Cancérologie de l´Association Française d’Urologie (CCAFU), Rennes, France
  • Herve Lang Department of Urology, Henri Mondor University Hospital, Creteil, France
  • Arnaud Mejean Department of Urology, Henri Mondor University Hospital, Creteil, France
  • Gregory Verhoest Department of Urology, St. Etienne University Hospital, St. Etienne, France
  • Jean-Jacques Patard Comité de Cancérologie de l´Association Française d’Urologie (CCAFU); and the Department of Urology, Rennes University Hospital, Rennes, France

DOI:

https://doi.org/10.5489/cuaj.978

Abstract

Objective: Based on combined data for 4880 patients, 2 previous studies reported that advanced age is a predictor of increased renal cell carcinoma–specific mortality (RCC-SM). We explored the effect of age in cubic spline analyses to identify the age groups with the most elevated risk for renal cell carcinoma (RCC).

Methods: Our study included 3595 patients from 14 European centres who had partial or radical nephrectomies. We used the Kaplan–Meier method to compile life tables, and we performed Cox regression analyses to assess RCC-SM. Covariates included age at diagnosis, sex, TNM (tumour, node, metastasis) stage, tumour size, Fuhrman grade, symptom classification and histological subtype.

Results: Age ranged from 10 to 89 (mean 63, median 67) years. The median duration of follow-up was 2.9 years. The median survival for the cohort was 13.4 years. Stage distribution was as follows: 1915 patients (53.3%) had stage I disease, 388 (10.8%) had stage II, 895 (24.9%) had stage III and 397 (11.0%) had stage IV disease. In multivariate analyses, we coded age at diagnosis as a cubic spline, and it achieved independent predictor status (p < 0.001). The risk of RCC-SM was lowest among patients younger than 50 years. We observed an increase in RCC-SM until the age of 50, at which point the level of risk reached a plateau. We observed a second increase among patients aged 75–89 years. We found similar patterns when we stratified patients according to the 2002 American Joint Committee on Cancer (AJCC) stages.

Conclusion: The effect of age shows prognostic significance and indicates that follow-up and possibly secondary treatments might need to be adjusted according to the age of the patient.

Downloads

Download data is not yet available.

Downloads

Published

2008-12-01

How to Cite

Karakiewicz, P. I., Jeldres, C., Suardi, N., Hutterer, G. C., Perrotte, P., Capitanio, U., Ficarra, V., Cindolo, L., de La Taille, A., Tostain, J., Mulders, P. F., Salomon, L., Zigeuner, R., Schips, L., Chautard, D., Valeri, A., Lechevallier, E., Descots, J.-L., Lang, H., Mejean, A., Verhoest, G., & Patard, J.-J. (2008). Age at diagnosis is a determinant factor of renal cell carcinoma– specific survival in patients treated with nephrectomy. Canadian Urological Association Journal, 2(6), 610. https://doi.org/10.5489/cuaj.978

Issue

Vol. 2 No. 6 (2008): CUAJ December

Section

Original Research

License

You, the Author(s), assign your copyright in and to the Article to the Canadian Urological Association. This means that you may not, without the prior written permission of the CUA:

  • Post the Article on any Web site
  • Translate or authorize a translation of the Article
  • Copy or otherwise reproduce the Article, in any format, beyond what is permitted under Canadian copyright law, or authorize others to do so
  • Copy or otherwise reproduce portions of the Article, including tables and figures, beyond what is permitted under Canadian copyright law, or authorize others to do so.

The CUA encourages use for non-commercial educational purposes and will not unreasonably deny any such permission request.

You retain your moral rights in and to the Article. This means that the CUA may not assert its copyright in such a way that would negatively reflect on your reputation or your right to be associated with the Article.

The CUA also requires you to warrant the following:

  • That you are the Author(s) and sole owner(s), that the Article is original and unpublished and that you have not previously assigned copyright or granted a licence to any other third party;
  • That all individuals who have made a substantive contribution to the article are acknowledged;
  • That the Article does not infringe any proprietary right of any third party and that you have received the permissions necessary to include the work of others in the Article; and
  • That the Article does not libel or violate the privacy rights of any third party.