; De Nunzio, Cosimo
; Tubaro, Andrea ; Coman, Ioan ; Truss, Michael ; Dalpiaz, Orietta ; Hoschke, Bernd ; Gilfrich, Christian
; Feciche, Bogdan ; Fenske, Fabian ; Sountoulides, Petros ; Figenshau, Robert S. ; Madison, Kerry ; Sánchez-Chapado, Manuel ; del Carmen Santiago Martin, Maria ; Wieland, Wolf F. ; Salzano, Luigi ; Lotrecchiano, Giuseppe ; Waidelich, Raphaela ; Stief, Christian ; Brookman-May, Sabine | Item type: | Article | ||||
|---|---|---|---|---|---|
| Journal or Publication Title: | Journal of Urology | ||||
| Publisher: | ELSEVIER SCIENCE INC | ||||
| Place of Publication: | NEW YORK | ||||
| Volume: | 191 | ||||
| Number of Issue or Book Chapter: | 2 | ||||
| Page Range: | pp. 310-315 | ||||
| Date: | 2014 | ||||
| Institutions: | Medicine > Lehrstuhl für Urologie | ||||
| Identification Number: |
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| 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 Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
| Status: | Published | ||||
| Refereed: | Yes, this version has been refereed | ||||
| Created at the University of Regensburg: | Yes | ||||
| Item ID: | 61780 |
Abstract
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 ...

Abstract
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.
Metadata last modified: 19 Dec 2024 08:13
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