Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Karakiewicz, PI; Jeldres, C; Suardi, N; Hutterer, GC; Perrotte, P; Capitanio, U; Ficarra, V; Cindolo, L; de La Taille, A; Tostain, J; Mulders, PF; Salomon, L; Zigeuner, R; Schips, L; Chautard, D; Valeri, A; Lechevallier, E; Descots, JL; Lang, H; Mejean, A; Verhoest, G; Patard, JJ.
Age at diagnosis is a determinant factor of renal cell carcinoma-specific survival in patients treated with nephrectomy.
Can Urol Assoc J. 2008; 2(6):610-617
Doi: 10.5489/cuaj.978
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- Co-Autor*innen der Med Uni Graz
- Hutterer Georg
- Zigeuner Richard
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- 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.