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Surgical waiting times and all-cause mortality in patients with non-metastatic renal cell carcinoma
Regional Cancer Centre Stockholm-Gotland, Stockholm, Sweden; Department of Medical Sciences, Division of Clinical Diabetology and Metabolism, Uppsala University, Uppsala, Sweden; Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden.
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Urology.ORCID iD: 0000-0003-0162-5881
Department of Oncology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
Department of Radiology, Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg University, Gothenburg, Sweden.
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2022 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 56, no 5-6, p. 383-390Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To examine the association between surgical waiting times (SWTs) and all-cause mortality (ACM) in non-metastatic patients with RCC, in relation to tumour stage.

PATIENTS AND METHODS: This nation-wide population-based cohort study included 9,918 M0 RCC patients registered in the National Swedish Kidney Cancer Register, between 2009 and 2021, followed-up for ACM until 9 December 2021, and having measured SWTs. The associations between primarily SWTs from date of radiological diagnosis to date of surgery (WRS) and secondarily SWTs from date of radiological diagnosis to date of treatment decision (WRT) and date of treatment decision to date of surgery (WTS), in relation to ACM, were analysed using Cox regression analysis, adjusted for clinical and demographic characteristics, stratified and unstratified according to T-stage.

RESULTS: During a mean follow-up time of 5 years (49,873 person-years), 23% (n = 2291) of the patients died. The adjusted hazard ratio (AHR) for WRS (months) for all patients was 1.03 (95% confidence interval [CI] = 1.02-1.04; p < 0.001). When subdividing WRS on T-stage, the AHRs were 1.03 (95% CI = 1.01-1.04; p < 0.001) and 1.05 (95% CI = 1.02-1.08; p = 0.003) for stages T1 and T3, respectively, while non-significant for T2 (p = 0.079) and T4 (p = 0.807). Similar results were obtained for WRT and WTS.

CONCLUSIONS: Prolonged SWTs significantly increased the risk of early overall death among patients with RCC. The increased risk of early death from any cause show the importance of shortening SWTs in clinical work of patients with this malignant disease.

Place, publisher, year, edition, pages
Taylor & Francis, 2022. Vol. 56, no 5-6, p. 383-390
Keywords [en]
T-stage, all-cause mortality, cryoablation, kidney cancer, nephrectomy, nephron sparing surgery, overall survival, radiofrequency ablation, renal cancer carcinoma, renal surgery, surgical waiting time, time-to-surgery
National Category
Cancer and Oncology Surgery
Identifiers
URN: urn:nbn:se:oru:diva-100729DOI: 10.1080/21681805.2022.2107067ISI: 000842796900001PubMedID: 35983600Scopus ID: 2-s2.0-85136527331OAI: oai:DiVA.org:oru-100729DiVA, id: diva2:1689041
Funder
Swedish Association of Local Authorities and RegionsAvailable from: 2022-08-22 Created: 2022-08-22 Last updated: 2023-01-19Bibliographically approved

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Sundqvist, PernillaLindblad, Per

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