Background and Objective: Five-year other cause mortality (OCM) after nephrectomy for non-metastatic renal cell carcinoma (RCC) should be marginal in properly selected surgical candidates. We examined 5-year OCM rates as a quality of care indicator for patient selection. Materials and Methods: Within the Surveillance, Epidemiology, and End Results database (1997-2011), we identified 59267 RCC patients treated with either radical (n = 27 804, 46.9%) or partial nephrectomy (n = 31 463, 53.1%). Temporal trends and multivariable Cox regression analyses assessed 5-year OCM. Data were stratified according to age group, year of diagnosis, race, marital status, gender, and socio-economic status. 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 <.001). The greatest decrease in 5-year OCM rates over time was recorded in patients >70 years (17.0%-9.6%, slope, −0.6%/y), as well as in African-Americans (12.0-6.2%; slope, −0.3%/y) and in males (8.9%-4.7%; slope, −0.3%, all P <.001). 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.

Assessment of other-cause mortality in localized renal cell carcinoma patients within 15 years : A population-based analysis / A. Pecoraro, S. Knipper, C. Palumbo, G. Rosiello, S. Luzzago, Z. Tian, S.F. Shariat, F. Saad, A. Briganti, C. Fiori, F. Porpiglia, P.I. Karakiewicz. - In: JOURNAL OF SURGICAL ONCOLOGY. - ISSN 0022-4790. - 122:7(2020), pp. 1506-1513. [10.1002/jso.26149]

Assessment of other-cause mortality in localized renal cell carcinoma patients within 15 years : A population-based analysis

S. Luzzago;
2020

Abstract

Background and Objective: Five-year other cause mortality (OCM) after nephrectomy for non-metastatic renal cell carcinoma (RCC) should be marginal in properly selected surgical candidates. We examined 5-year OCM rates as a quality of care indicator for patient selection. Materials and Methods: Within the Surveillance, Epidemiology, and End Results database (1997-2011), we identified 59267 RCC patients treated with either radical (n = 27 804, 46.9%) or partial nephrectomy (n = 31 463, 53.1%). Temporal trends and multivariable Cox regression analyses assessed 5-year OCM. Data were stratified according to age group, year of diagnosis, race, marital status, gender, and socio-economic status. 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 <.001). The greatest decrease in 5-year OCM rates over time was recorded in patients >70 years (17.0%-9.6%, slope, −0.6%/y), as well as in African-Americans (12.0-6.2%; slope, −0.3%/y) and in males (8.9%-4.7%; slope, −0.3%, all P <.001). 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.
kidney cancer; partial nephrectomy; radical nephrectomy; SEER; survival; Adult; Aged; Aged, 80 and over; Carcinoma, Renal Cell; Female; Humans; Kidney Neoplasms; Male; Middle Aged; Nephrectomy; Proportional Hazards Models; Quality Indicators, Health Care; SEER Program
Settore MED/24 - Urologia
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/881537
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