Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
May, M; Cindolo, L; Zigeuner, R; De Cobelli, O; Rocco, B; De Nunzio, C; Tubaro, A; Coman, I; Truss, M; Dalpiaz, O; Wolff, I; Feciche, B; Fenske, F; Pichler, M; Schips, L; Figenshau, RS; Madison, K; Sánchez-Chapado, M; Santiago Martin, Mdel C; Salzano, L; Lotrecchiano, G; Waidelich, R; Stief, C; Sountoulides, P; Brookman-May, S; Members of CORONA project; Young Academic Urologists Renal Cancer Group.
Results of a comparative study analyzing octogenarians with renal cell carcinoma in a competing risk analysis with patients in the seventh decade of life.
Urol Oncol. 2014; 32(8):1252-1258
Doi: 10.1016/j.urolonc.2014.04.013
Web of Science
PubMed
FullText
FullText_MUG
- Co-Autor*innen der Med Uni Graz
- Dalpiaz Orietta
- Pichler Martin
- Zigeuner Richard
- Altmetrics:
- Dimensions Citations:
- Plum Analytics:
- Scite (citation analytics):
- Abstract:
- To analyze clinicopathological features and survival of surgically treated patients with renal cell carcinoma (RCC) ≥ 80 years of age in comparison with patients between the ages of 60 and 70 years. The data for 2,516 patients with a median follow-up of 57 months were retrieved from a multinational database (Collaborative Research on Renal Neoplasms Association [CORONA]), including data for 6,234 consecutive patients with RCC after radical or partial nephrectomy. Comparative analysis of clinicopathological features of 241 octogenarians (3.9% of the database) and 2,275 reference patients between the ages of 60 and 70 years (36.5%) was performed. Multivariable regression analysis adjusted for competing risks was applied to identify the effect of advanced age on cancer-specific mortality (CSM) and other-cause mortality (OCM). Furthermore, instrumental variable analysis was employed to reduce residual confounding by unmeasured parameters. Significantly more women were present (50% vs. 40%, P = 0.004), and significantly less often nephron-sparing surgery was performed in octogenarians compared with the reference group (11% vs. 20%, P<0.001). Although median tumor size and stages did not significantly defer, older patients less often had advanced or metastatic disease (N+/M1) (4.6% vs. 9.6%, P = 0.009). On multivariable analysis, higher CSM (hazard ratio = 1.48, P = 0.042) and OCM rates (hazard ratio = 4.32, P<0.001) were detectable in octogenarians (c-indices = 0.85 and 0.72, respectively). Integration of the variable age group in multivariable models significantly increased the predictive accuracy regarding OCM (6%, P<0.001), but not for CSM. Limitations are based on the retrospective study design. Octogenarian patients with RCC significantly differ in clinical features and display significantly higher CSM and OCM rates in comparison with their younger counterparts. Copyright © 2014 Elsevier Inc. All rights reserved.
- Find related publications in this database (using NLM MeSH Indexing)
- Age Factors -
- Aged -
- Aged, 80 and over -
- Carcinoma, Renal Cell - mortality
- Carcinoma, Renal Cell - pathology
- Carcinoma, Renal Cell - surgery
- Female -
- Humans -
- Kidney Neoplasms - mortality
- Kidney Neoplasms - pathology
- Kidney Neoplasms - surgery
- Male -
- Prognosis -
- Risk Assessment -
- Survival Rate -
- Treatment Outcome -
- Find related publications in this database (Keywords)
- Renal cell carcinoma
- Octogenarians
- Nephrectomy
- Cancer-specific mortality
- Competing risks regression analysis
- Instrumental variable