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Baudo, A; Incesu, RB; Morra, S; Scheipner, L; Jannello, LMI; de, Angelis, M; Siech, C; Tian, Z; Acquati, P; Tilki, D; Longo, N; Ahyai, S; de, Cobelli, O; Briganti, A; Chun, FKH; Saad, F; Shariat, SF; Carmignani, L; Karakiewicz, PI.
Other-Cause Mortality, According to Partial vs. Radical Nephrectomy: Age and Stage Analyses.
Clin Genitourin Cancer. 2023; Doi: 10.1016/j.clgc.2023.10.011
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Co-authors Med Uni Graz: Ahyai Sascha; Scheipner Lukas
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Abstract:: INTRODUCTION: We tested the association between other-cause mortality and partial vs. radical nephrectomy in patients with T1a, T1b, and T2 renal cell carcinoma, across all patient ages. MATERIAL AND METHODS: Within the Surveillance, Epidemiology, and End Results database (2010-2020), patients with localized renal cell carcinoma stages (T1a-T1b-T2, N0, M0), who underwent partial or radical nephrectomy were identified. Only patients with tumor size 2 to 10 cm were included. Cumulative incidence plots and multivariable competing risks regression models were used. RESULTS: Of 68,195 patients, 28,845 (42%) underwent partial nephrectomy vs. 39,350 (58%) radical nephrectomy. In T1a patients, 5-year other-cause mortality rates were 6% for partial nephrectomy vs. 11% for radical nephrectomy (Δ=5%). In T1a patients, partial nephrectomy independently predicted lower other-cause mortality, across all ages (HR: 0.73, P < .001). In age category subgroup analyses addressing T1a patients, in all age categories, partial nephrectomy invariably predicted lower other-cause mortality than radical nephrectomy: ≤59 years (HR: 0.67, P < .001); 60 to 69 years (HR: 0.70, P < .001); and ≥70 years (HR: 0.79, P < .001). Finally, in T1b patients, as well as in T2 patients, no other-cause mortality advantage was recorded for partial vs. radical nephrectomy: T1b (8 vs. 10%, Δ=2%); T2 (8 vs. 9%, Δ=1%). CONCLUSIONS: Relative to radical nephrectomy, partial nephrectomy is associated with lower other-cause mortality in stage T1a renal cell carcinoma patients across all age categories, including the oldest patients. Conversely, no clinically meaningful other-cause mortality benefit was associated with partial nephrectomy in stages T1b or T2, regardless of age, including youngest patients.
Find related publications in this database (Keywords): Kidney cancer; Multivariable analyses; Renal cell carcinoma; SEER program; Survival differences