The effect of age on cancer-specific mortality in patients with small renal masses: A population-based analysis

Abstract

Introduction: Contemporary data regarding the effect of age, especially in the elderly patients, on cancer-specific mortality (CSM) for pT1a renal cell cancer (RCC) are lacking. The objective of the current study is to evaluate CSM in a large population-based cohort of surgically treated pT1a RCC patients according to age groups. Methods: Within the Surveillance Epidemiology and End Results database (2000-2013), we identified 37 121 pT1a RCC patients who underwent either partial or radical nephrectomy. The population was stratified into five groups according to decades: <50, 50-59, 60-69, 70-79, and ≥80 years. The effect of age on CSM was evaluated using competing risks regression models according to Fuhrman grade (FG). Analyses were repeated in clear-cell RCC (ccRCC). Results: Patients aged 50-59 (9615), 60-69 (10 762), 70-79 (7096), and ≥80 (1789) years demonstrated higher rate of CSM compared to patients aged <50 (7856) yrs (hazard ratios [HR] 2.11, 3.04, 4.47, and 7.56, respectively; all p<0.001). The effect of age on CSM in FG 1-2 patients resulted in HRs ranged from 2.01-8.23 for the same age decades (all p< 0.001). Similarly, the effect of age on CSM in FG 3-4 patients resulted in HRs ranged from 2.38-5.92, respectively (all p< 0.001). Virtually the same results were recorded in ccRCC patients. Conclusions: Older age is associated with higher CSM in surgically treated patients with pT1a RCC. This effect seems to be more pronounced in patient with FG 1-2 disease. This observation should be considered in treatment decision-making in elderly patients.

Clinical T1a Renal Cell Carcinoma, Not Always a Harmless Disease—A National Register Study

“…Women were significantly older than men in our study, in line with previous findings [20] , [21] . The reason for this difference in age distribution between genders is unclear.…”

Validation of the GRade, Age, Nodes and Tumor (GRANT) score within the Surveillance Epidemiology and End Results (SEER) database: A new tool to predict survival in surgically treated renal cell carcinoma patients

“…The main inclusion criteria was histologically confirmed (International Classification of Disease for Oncology C64.9 16 ) non-metastatic (M0 at diagnosis) RCC stage pT 1-4 N any . Death certificate only, autopsy cases, and patients with bilateral tumors were excluded 16,17 . The histological subtypes allowed for the inclusion were clear-cell RCC (ccRCC - histologic code 8310) and papillary RCC (pRCC - histologic code 8260).…”

Racial/ethnic disparities in renal cell carcinoma: Increased risk of early‐onset and variation in histologic subtypes

“…Incidence of kidney cancer in younger age groups has increased more than older age groups between 2001 and 2010 and much more rapidly in younger AIs/ANs (age 20‐49) . Cancer specific mortality rates seems to be lower in younger patients than older patients . However, patients who are diagnosed at a young age are more likely to have a hereditary condition and are also likely to have recurrence and multifocal and bilateral RCC than patients with sporadic RCC who are often diagnosed older age .…”

“…3 Cancer specific mortality rates seems to be lower in younger patients than older patients. [28][29][30] However, patients who are diagnosed at a young age are more likely to have a hereditary condition and are also likely to have recurrence and multifocal and bilateral RCC than patients with sporadic RCC who are often diagnosed older age. 31 Thus, it is important to understand who are more likely to be diagnosed at a younger age.…”