1105: Stage Migration in Renal Cell Carcinoma Patients Demonstrated by Analysis of the National Cancer Database, 1993-2003
Year: 2006
Type: conference-abstract
Abstract: INTRODUCTION AND OBJECTIVE: Significant advances in the diagnosis, staging, and treatment of patients with renal cell carcinoma (RCC) during the last 2 decades have resulted in improved survival of a select group of patients and an overall change in the natural history of the disease.We describe the pathologic characteristics and long-term survival in patients treated for RCC at a single tertiary care institution.METHODS: Between 1990 and 2005, 1431 patients that underwent surgical resection for a renal mass were evaluated for differences in surgical characteristics, pathologic RESULTS:, and survival.Survival based on the UCLA Integrated Staging System (UISS) was also evaluated.Data was analyzed using standard statistical methods.Results: RCC at pathologic evaluation following surgical resection was found in 1269 patient.Of these patients, 473 had evidence of metastatic dissemination at time of surgery.Radical nephrectomy and adrenalectomy were performed more frequently in patients with metastatic disease compared to patients without metastases (95.2% vs. 67.0%,p <0.001, and 78.6% vs. 46.9%,p <0.001, respectively).The primary tumor in patients with metastatic disease was more likely to be clear cell (78.8% vs. 72.9%,p=0.02), collecting duct (1.3% vs. 0.1 %, p=0.01 ), or undifferentiated (4.8% vs. 1.6%, p=0.002)RCC, and less likely to be papillary (12.0% vs. 18.7%, p=0.002) or chromophobe (3.1% vs. 6.7%, p=0.006) compared to patients with non-metastatic disease, respectively.The 2-year, 5-year, and 1 0-year survival was significantly higher in non-metastatic patients compared to patients with metastatic disease present at time of surgery (87.0% vs. 42.4%,70.0 vs. 21.8%,50.0% vs. 16.5%,p <0.001, respectively).CONCLUSIONS: Over the last 15 years at our institution, patients without metastatic disease at the time of surgery have improved survival rates, are more likely to have papillary cell or chromophobe primary tumors, and undergo nephron-and adrenal-sparing procedures more often than patients with metastatic disease.In addition, the UISS stratification provides a significant prediction of long-term survival.
Source: The Journal of Urology
Authors: Christopher J. Kane, Matthew R. Cooperberg, Jamie Richey, Andrew K. Stewart, Peter R. Carroll
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,000
OpenAlex ID: W2791369898