PD41-01 THE EFFECT OF TIME ELAPSED FROM SURGERY ON THE SUBSEQUENT RISK OF CANCER SPECIFIC MORTALITY IN RENAL CELL CARCINOMA PATIENTS

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV1 Apr 2016PD41-01 THE EFFECT OF TIME ELAPSED FROM SURGERY ON THE SUBSEQUENT RISK OF CANCER SPECIFIC MORTALITY IN RENAL CELL CARCINOMA PATIENTS Paolo Dell’Oglio, Alessandro Larcher, Giovanni La Croce, Paolo Capogrosso, Alessandro Nini, Armando Stabile, Ettore Di Trapani, Pierre Karakiewicz, Alberto Briganti, Francesco Montorsi, Umberto Capitanio, and Roberto Bertini Paolo Dell’OglioPaolo Dell’Oglio More articles by this author , Alessandro LarcherAlessandro Larcher More articles by this author , Giovanni La CroceGiovanni La Croce More articles by this author , Paolo CapogrossoPaolo Capogrosso More articles by this author , Alessandro NiniAlessandro Nini More articles by this author , Armando StabileArmando Stabile More articles by this author , Ettore Di TrapaniEttore Di Trapani More articles by this author , Pierre KarakiewiczPierre Karakiewicz More articles by this author , Alberto BrigantiAlberto Briganti More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , Umberto CapitanioUmberto Capitanio More articles by this author , and Roberto BertiniRoberto Bertini More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1547AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In patients with renal cell carcinoma (RCC), the chance to die from cancer is not negligible and may change significantly according to the time elapsed from surgery. In this study we assessed long-term survival patterns in patients with RCC and the risk of cancer specific mortality (CSM) in patients who survived after nephrectomy, after accounting for the risk of death for other cause. METHODS We relied on 1,728 RCC patients treated with radical or partial nephrectomy between 1987 and 2014. Patients with distant metastases, bilateral lesions, history of Von Hippel Lindau disease and previous history of renal tumor were excluded. Smoothed cumulative incidence method was performed to assess CSM and other cause mortality (OCM) rates at 10 years after surgery in the overall population and after stratification according to age (<60 vs. ≥60) and pathologic stage (pT1 vs. pT2 vs. pT3-T4). The same analyses were performed to assess the 5-year probability of CSM and OCM in patients who survived 5 years after surgery. A multivariable competing risk regression model was fitted to identify predictors of CSM and OCM. RESULTS The 10-year CSM and OCM rates in patients aged <60 years were 3.7 and 3.5% in pT1 vs. 16.5 and 7.0% in pT2 vs. 27.2 and 6.5% in pT3-4, respectively. In patients aged <60 years, the 5-year probability of CSM and OCM rates among patients who survived at 5 years after surgery, were 1.9 and 1.6% in pT1 vs. 4.1 and 8.1% in pT2 vs. 6.9 and 5.1% in pT3-4, respectively. The 10-year CSM and OCM rates in patients aged ≥60 years were 7.4 and 21.3% in pT1 vs. 18.1 and 24.6% in pT2 vs. 38.2 and 22.3% in pT3-4, respectively. In patients aged ≥60 years, the 5-year probability of CSM and OCM rates among patients who survived at 5 years after surgery, were 5.1 and 14.2% in pT1 vs. 9.9 and 19.8% in pT2 vs. 18.2 and 16.7% in pT3-4, respectively. Pathological stage, Fuhrman grade and lymph node invasion were the major determinants of CSM (all p<0.001). Conversely, age and Charlson comorbidity index were significantly associated with OCM (all p<0.001). CONCLUSIONS The probability of succumbing to CSM after accounting for the risk of death for other cause in RCC patients change according to age and pathologic characteristics. In clinical practice, the current study helps the physicians to give an approximate CSM rates adjusted to mortality-free interval according to age and pathologic stage, in patients who survived 5-years after surgery. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e940 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Paolo Dell’Oglio More articles by this author Alessandro Larcher More articles by this author Giovanni La Croce More articles by this author Paolo Capogrosso More articles by this author Alessandro Nini More articles by this author Armando Stabile More articles by this author Ettore Di Trapani More articles by this author Pierre Karakiewicz More articles by this author Alberto Briganti More articles by this author Francesco Montorsi More articles by this author Umberto Capitanio More articles by this author Roberto Bertini More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...