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Predictive characteristics for disease recurrence and overall survival in non-metastatic clinical T1 renal cell carcinoma: results from the National Swedish Kidney Cancer Register
Department of Surgery and Urology, Eskilstuna Country Hospital, Eskilstuna, Sweden.
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, Solna, Sweden.ORCID iD: 0000-0003-3691-8326
Department of Radiology, Sahlgrenska Academy/Sahlgrenska University Hospital, Gothenburg University, Gothenburg, Sweden.
Department of Urology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
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2023 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 57, no 1-6, p. 67-74Article in journal (Refereed) Published
Abstract [en]

Objective:  Patients with clinical T1 renal cell carcinoma (cT1RCC) have risks for recurrence and reduced overall survival despite being in the best prognostic group. This study aimed to evaluate the association of different treatments on disease recurrence and overall survival using clinical and pathological characteristics in a nation-wide cT1RCC cohort.

Materials and methods: A total of 4,965 patients, registered in the National Swedish Kidney Cancer Register (NSKCR) between 2005 and 2014, with ≥ 5-years follow-up were identified: 3,040 males and 1,925 females, mean age 65 years. Times to recurrence and overall survival were analyzed with Kaplan-Meier curves, log-rank test, and Cox regression models.

Results: Age, TNM-stage, tumor size, RCC-type, and performed treatment were all associated with disease recurrence. Patients selected for ablative treatments had increased risk for recurrent disease: hazard ratio (HR) = 3.79 [95% confidence interval (CI) = 2.69-5.32]. In multivariate analyses, age, gender, tumor size, RCC-type, N-stage, recurrence and performed treatment were all independently associated with overall survival. Patients with chRCC had a 41% better overall survival (HR = 0.59, 95% CI = 0.44-0.78; p < 0.001) than ccRCC. Patients treated with partial nephrectomy (PN) had an 18% better overall survival (HR = 0.83, 95% CI = 0.71-0.95, p < 0.001) than patients treated with radical nephrectomy.

Conclusions: Age, gender, T-stage, tumor size, RCC type and treatment modality are all associated with risk of recurrence. Furthermore, age, male gender, tumor size, N-stage and recurrence are associated with reduced overall survival. Patients with chRCC, compared with ccRCC and pRCC patients, and PN compared with RN treated patients, had an advantageous overall survival, indicating a possible survival advantage of nephron sparing treatment.

Place, publisher, year, edition, pages
Taylor & Francis, 2023. Vol. 57, no 1-6, p. 67-74
Keywords [en]
RCC type, Radical nephrectomy, T-stage, TNM stage, cryoablation, overall survival, partial nephrectomy, radiofrequency ablation, renal cell carcinoma, tumor recurrence, tumor size.
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:oru:diva-102746DOI: 10.1080/21681805.2022.2154383ISI: 000897992900001PubMedID: 36520023Scopus ID: 2-s2.0-85144116341OAI: oai:DiVA.org:oru-102746DiVA, id: diva2:1719686
Available from: 2022-12-15 Created: 2022-12-15 Last updated: 2023-05-19Bibliographically approved

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Lindblad, PerSundqvist, Pernilla

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Karlsson Rosenblad, AndreasLindblad, PerLundstam, SvenSundqvist, PernillaLjungberg, Börje
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