Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
de, Angelis, M; Morra, S; Scheipner, L; Siech, C; Jannello, LMI; Baudo, A; Goyal, JA; Tian, Z; Longo, N; Ahyai, S; de, Cobelli, O; Chun, FKH; Saad, F; Shariat, SF; Carmignani, L; Montorsi, F; Briganti, A; Karakiewicz, PI.
Cancer-specific mortality in non-metastatic T1a renal cell carcinoma treated with radiotherapy versus partial nephrectomy.
World J Urol. 2024; 42(1):193
Doi: 10.1007/s00345-024-04856-y
Web of Science
PubMed
FullText
FullText_MUG
- Co-Autor*innen der Med Uni Graz
- Ahyai Sascha
- Scheipner Lukas
- Altmetrics:
- Dimensions Citations:
- Plum Analytics:
- Scite (citation analytics):
- Abstract:
- PURPOSE: Radiotherapy (RT) represents a treatment option for small renal masses with proven feasibility and tolerability. However, it has never been directly compared to partial nephrectomy (PN) with cancer-specific mortality (CSM) as an endpoint. METHODS: Within the Surveillance, Epidemiology, and End Results database (2004-2020), we identified T1aN0M0 renal cell carcinoma (RCC) patients treated with RT or PN. We relied on 1:1 propensity score matching (PSM) for age, tumor size and histology. Subsequently, cumulative incidence plots and multivariable competing risks regression (CRR) models were fitted. The same methodology was then re-applied to a subset of patients with tumor size 21-40 mm. RESULTS: Of 40,355 patients with T1aN0M0 RCC, 40,262 underwent PN (99.8%) vs 93 underwent RT (0.2%). RT patients were older (median age 72 vs 60 years, p < 0.001) and harbored larger tumor size (median size 28 vs 25 mm, p < 0.001) and a higher proportion of non-clear cell RCC (49% vs 22%, p < 0.001). After 1:1 PSM (92 RT versus 92 PN patients), cumulative incidence plots' derived CSM was 21.3 vs 4%, respectively. In multivariable CRR models, RT independently predicted higher CSM (hazard ratio (HR) 4.3, p < 0.001). In the subgroup with tumor size 21-40 mm, after 1:1 PSM (72 RT versus 72 PN patients), cumulative incidence plots derived CSM was 21.3% vs 4%, respectively. In multivariable CRR models, RT also independently predicted higher CSM (HR 4.7, p = 0.001). CONCLUSIONS: In T1aN0M0 RCC patients, relative to PN, RT is associated with significantly higher absolute and relative CSM, even in patients with tumor size 21-40 mm.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Aged - administration & dosage
- Carcinoma, Renal Cell - pathology
- Kidney Neoplasms - pathology
- Nephrectomy - methods
- Proportional Hazards Models - administration & dosage
- Incidence - administration & dosage
- Find related publications in this database (Keywords)
- Renal cell carcinoma
- Cancer-specific mortality
- Radiotherapy
- Partial nephrectomy
- Small renal mass