PURPOSE: To analyze distinct clinico-pathological features and prognosis of patients with renal cell carcinoma aged ≤ 40 years in comparison to a reference group of patients aged 60-70 years.
MATERIALS AND METHODS: Overall 2.572 patients retrieved from a multi-center international database comprising of 6.234 patients with surgically treated renal cell carcinoma were included in this retrospective study. Clinical and histopathological features of 297 patients aged ≤ 40 years (4.8%) were analyzed in comparison with 2275 patients (36.5%) aged 60-70 years, who represented the reference group. The median follow-up was 59 months. The impact of young age and further parameters on disease-specific mortality and all-cause mortality was evaluated by multivariable Cox proportional-hazards regression analyses.
RESULTS: Young patients underwent more frequently nephron-sparing surgery (27% vs. 20%; p=0.008) and regional lymph node dissection in comparison to older patients (38% vs. 32%; p=0.025). Organ-confined tumor stages (81% vs. 70%; p< 0.001), smaller tumor diameters (4.5 cm vs. 4.7 cm; p=0.014), and chromophobe subtype (10% vs. 4%; p< 0.001) were significantly more frequent in young patients. On multivariable analysis, older patients had a higher disease-specific (HR 2.21; p< 0.001) and all-cause mortality (HR 3.05; p< 0.001). The c-indices for the Cox models were 0.87 and 0.78, respectively. However, integration of the variable age group did not significantly gain predictive accuracy of the disease-specific and all-cause-mortality models.
CONCLUSION: Young renal cell carcinoma patients (≤ 40 years) display significantly different frequencies of clinical and histopathological features and show a significantly lower all-cause and disease-specific mortality compared to patients at the age between 60-70 years.
Written by:
Aziz A, May M, Zigeuner R, Pichler M, Chromecki T, Cindolo L, Schips L, De Cobelli O, Rocco B, De Nunzio C, Tubaro A, Coman I, Truss M, Dalpiaz O, Hoschke B, Gilfrich C, Feciche B, Fenske F, Sountoulides P, Figenshau RS, Madison K, Sánchez-Chapado M, Martin MD, Wieland WF, Salzano L, Lotrecchiano G, Waidelich R, Stief C, Brookman-May S. Are you the author?
University of Regensburg, Caritas St. Josef Medical Center, Dept. of Urology, Regensburg, Germany.
Reference: J Urol. 2013 Aug 20. pii: S0022-5347(13)05141-0.
doi: 10.1016/j.juro.2013.08.021
PubMed Abstract
PMID: 23973516
UroToday.com Renal Cancer Section
