Dokumentenart: | Artikel | ||||
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Titel eines Journals oder einer Zeitschrift: | Journal of Urology | ||||
Verlag: | ELSEVIER SCIENCE INC | ||||
Ort der Veröffentlichung: | NEW YORK | ||||
Band: | 191 | ||||
Nummer des Zeitschriftenheftes oder des Kapitels: | 2 | ||||
Seitenbereich: | S. 310-315 | ||||
Datum: | 2014 | ||||
Institutionen: | Medizin > Lehrstuhl für Urologie | ||||
Identifikationsnummer: |
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Stichwörter / Keywords: | INDEPENDENT PROGNOSTIC-FACTOR; CANCER-SPECIFIC SURVIVAL; NATURAL-HISTORY; OLD PATIENTS; ADULTS; TUMORS; ADENOCARCINOMA; BLADDER; STAGE; carcinoma; renal cell; age factors; nephrectomy; neoplasms by histologic type; outcome assessment | ||||
Dewey-Dezimal-Klassifikation: | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin | ||||
Status: | Veröffentlicht | ||||
Begutachtet: | Ja, diese Version wurde begutachtet | ||||
An der Universität Regensburg entstanden: | Ja | ||||
Dokumenten-ID: | 61780 |
Zusammenfassung
Purpose: We analyzed the distinct clinicopathological features and prognosis of patients with renal cell carcinoma age 40 years or less compared to a reference group of patients 60 to 70 years old. Materials and Methods: Overall 2,572 patients retrieved from a multicenter international database comprised of 6,234 patients with surgically treated renal cell carcinoma were included in this ...
Zusammenfassung
Purpose: We analyzed the distinct clinicopathological features and prognosis of patients with renal cell carcinoma age 40 years or less compared to a reference group of patients 60 to 70 years old. Materials and Methods: Overall 2,572 patients retrieved from a multicenter international database comprised of 6,234 patients with surgically treated renal cell carcinoma were included in this retrospective study. Clinical and histopathological features of 297 patients 40 years old or younger (4.8%) were compared to those of 2,275 patients (36.5%) 60 to 70 years old, who served as the reference group. Median followup was 59 months. The impact of young age and further parameters on disease specific mortality and all cause mortality was evaluated by multivariate Cox proportional hazards regression analyses. Results: Young patients more frequently underwent nephron sparing surgery (27% vs 20%, p = 0.008) and regional lymph node dissection compared to older patients (38% vs 32%, p = 0.025). Organ confined tumor stage (81% vs 70%, p < 0.001), smaller tumor diameter (4.5 vs 4.7 cm, p = 0.014) and chromophobe subtype (10% vs 4%, p < 0.001) were significantly more frequent in young patients. On multivariate analysis older patients had a higher disease specific (HR 2.21, p < 0.001) and all cause mortality (HR 3.05, p < 0.001). The c indices for the Cox models were 0.87 and 0.78, respectively. However, integration of the variable age group did not significantly increase the predictive accuracy of the disease specific and all cause mortality models. Conclusions: Young patients with renal cell carcinoma (40 years old or younger) have significantly different frequencies of clinical and histopathological features, and a significantly lower all cause and disease specific mortality compared to patients 60 to 70 years old.
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