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.
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.
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.
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.
Scandinavian journal of urology. 2022 Aug 18 [Epub ahead of print]
Andreas Karlsson Rosenblad, Pernilla Sundqvist, Ulrika Harmenberg, Mikael Hellström, Fabian Hofmann, Anders Kjellman, Britt-Inger Kröger Dahlin, Per Lindblad, Magnus Lindskog, Sven Lundstam, Börje Ljungberg
Regional Cancer Centre Stockholm-Gotland, Stockholm, Sweden., Department of Urology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden., Department of Oncology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden., Department of Radiology, Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg University, Gothenburg, Sweden., Department of Urology, Umeå University, Luleå, Sweden., Department of Urology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden., Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden., School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden., Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden., Departments of Urology and Oncology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.