Co-morbidities may induce local and systemic tumor progression of renal cell carcinoma (RCC); however, the prognostic impact of co-morbidities has not yet been well characterized.
RCC patients (n = 2206) surgically treated at three academic institutions in the US and Europe were included in the analysis. Presence of diabetes mellitus, hypertension, chronic kidney disease, chronic obstructive pulmonary disease, coronary heart disease, and hypothyroidism were investigated for their association with clinicopathological features and cancer-specific survival.
Hypertension was associated with less advanced T stages (p = 0.025), a lower risk of lymph-node (p = 0.026) and distant metastases (p = 0.001), and improved cancer specific survival in univariable analysis (HR 0.81 95% CI 0.69-0.96, p = 0.013). However, hypertension was not an independent prognostic factor after adjustment for TNM stages, grading, and ECOG performance status (HR 0.95, 95% CI 0.80-1.12; p = 0.530). A correlation between the use of concomitant anti-hypertensive medications and improved survival outcome was not identified. All other investigated co-morbidities did not show significant associations with clinicopathological features or cancer-specific survival.
Although the investigated co-morbidities are capable or inducing pathophysiological changes that are predisposing factors for tumor progression, none is an independent prognostic factor in patients with RCC.
World journal of urology. 2019 Sep 13 [Epub ahead of print]
Johannes Heide, Silvia Ribback, Tobias Klatte, Shahrokh Shariat, Martin Burchardt, Frank Dombrowski, Arie S Belldegrun, Alexandra Drakaki, Allan J Pantuck, Nils Kroeger
Department of Urology, University Medicine at the Ernst-Moritz-Arndt-University Greifswald, F. Sauerbruch Str, 17475, Greifswald, Germany., Institute of Pathology, University Medicine at the Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany., Department of Urology, Medical University of Vienna, Vienna, Austria., Department of Urology at the David Geffen-School of Medicine, Institute of Urologic Oncology, University of California Los Angeles, Los Angeles, CA, USA., Department of Urology, University Medicine at the Ernst-Moritz-Arndt-University Greifswald, F. Sauerbruch Str, 17475, Greifswald, Germany. .