PD11: Kidney Cancer: Localized: Surgical Therapy II
PD11-03: Assessment of other-cause mortality in T1aN0M0 renal cell carcinoma patients with 15 years of follow-up: a SEER-based analysis
Friday, May 15, 2020
7:00 AM – 9:00 AM
Angela Pecoraro, Sophie Knipper, Carlotta Palumbo, Giuseppe Rosiello, Stefano Luzzago, Marina Deuker, Zhe Tian, Shahrokh F. Shariat, Fred Saad, Alberto Briganti, Cristian Fiori, Francesco Porpiglia, Pierre I. Karakiewicz
Introduction: Five-year other cause mortality (OCM) after nephrectomy for non-metastatic renal cell carcinoma (nmRCC) should be marginal in properly selected surgical candidates. We examined 5-year OCM rates as a quality of care indicator for patient selection.
Methods: Within the Surveillance, Epidemiology, and End Results database (1997-2011), we identified 59267 RCC patients treated with either radical (RN, 27804, 46.9%) or partial nephrectomy (PN, n=31463, 53.1%). Temporal trends and multivariable Cox regression analyses assessed 5-year OCM. Data were stratified according to age group (<60 vs. 60-70 vs. >70 years), year of diagnosis (1997-2001 vs. 2002-2006 vs. 2007-2011), race, marital status, gender, and socio-economic status (SES).
Results: The overall OCM rates for the entire cohort at 5 years of follow-up was 4.7% and decreased from 9.4 to 5.6% over the study span (-3.8%, p<0.001). The greatest decrease in 5-year OCM rates over time was recorded in patients >70 years (17.0-9.6%, slope: -0.6%/year), as well as in African-Americans (12.0-6.2%, slope: -0.3%/year) and in males (8.9-4.7%, slope: -0.3%, all p<0.001). Multivariable Cox regression models corroborated these findings.
Conclusions: An important OCM decrease was recorded over the study span. Nonetheless, further improvement may be accomplished, especially in African-Americans, unmarried and older individuals, who exhibited higher OCM rates than others. These three groups may represent ideal targets for better patient selection based on OCM considerations. Source of