Prognostic significance of laterality in renal cell carcinoma: A population‐based study from the surveillance, epidemiology, and end results (SEER) database

Abstract

Background Various prognostic characteristics have been established in the renal cell carcinoma (RCC). However, the impact of tumor laterality is unknown. The objective of the current study was to explore the predictive and prognostic impact of tumor laterality of RCC after surgery. Methods This investigation was a population‐based retrospective cohort study of patients with RCC from the surveillance, epidemiology, and end results (SEER) database in the USA. All patients received surgical treatment between January 2010 and December 2014. Cancer‐specific survival (CSS) measured from the time of surgery. Results This study identified 41 138 surgically treated RCC patients: Of these patients, 50.6% had right‐sided RCC, 59.5% were younger than 65 years of age, 63.8% were male, and 81.0% were Caucasian. The stage distribution was 67.0% (I), 9.5% (II), 17.1% (III), and 6.4% (IV). Patients with right‐sided RCC were more likely to have favorable clinicopathological features compared with patients with left‐sided RCC. In adjusted analyses, patients with right‐sided RCC showed significantly better CSS than those with left‐sided RCC within different subgroups including tumor size ≥10 cm (P = .004), age <65 years (P = .002), male gender (P = .001), Caucasian race (P = .001), clear cell carcinoma type (P = .024), and radical nephrectomy (P = 0.008). Moreover, in the subgroup of tumor size ≥10 cm, right‐sided cancer was an independent predictor of CSS (P = .022). Conclusion Right‐sided RCC is associated with more early‐stage, low‐grade disease and shows better CSS than left‐sided RCC. Moreover, laterality remained as an independent prognostic factor for cancer‐specific survival in subgroup of tumor size ≥10 cm RCC.

RGS5 plays a significant role in renal cell carcinoma

“…We also observed that the survived female patients have a significantly higher expression level of RGS5 compared with other categories (figure 5). Moreover, some studies reported better clinical results such as low grade tumours and better survival in patients with right-sided RCC compared with the left-sided RCC [34,35], but our result shows no significant difference between the expression level of RGS5 in female versus male patients with primary tumours located in the right kidney. However, among patients with primary tumours in the left kidney, female patients have a significantly higher RGS5 expression level (figure 4).…”

Development and Validation of a Predictive Model to Evaluate the Risk of Bone Metastasis in Kidney Cancer

“…As we have known, the left renal vein has more vascular collateral circulation, which brings together multiple veins of the lumbar region and may induce more metastasis. Therefore, the left tumors may develop more metastasis than those on the right side (39). This idea is also reflected in the report of Morri et al (40) Owing to the concern for laterality, surgeons usually remove left lesions as possible, which leads to more negative margins being observed in left-sided cases.…”

Clinical features and prognostic factors of patients with metastatic renal cell carcinoma stratified by age

“…Further analysis indicated that surgery and chemotherapy were independent prognostic factors for elderly patients, which is in agreement with previous studies of other cancers [ 23 – 25 ]. Moreover, treatments, such as surgery or chemotherapy, have already been proven to be prognostic factors for renal cancer [ 6 , 7 , 11 , 28 ]. Regarding other clinical characteristics, such as the year of diagnosis and laterality, although there were significant differences between the elderly group and the two younger groups, there was no trend of change with age.…”