ATLANTA—New findings may better enable clinicians to predict cancer-specific and other-cause mortality among patients who have undergone nephrectomy for renal cell carcinoma (RCC), according to a report presented at the American Urological Association 2012 annual meeting.
Investigators identified 42,090 patients treated with nephrectomy between 1988 and 2008. Overall, 11,153 patients died (27%). Of these deaths, 5,554 (50%) were due to cancer-specific mortality (CSM) events.
Among patients with low-grade tumors, the highest CSM rate (63%) at five years was found in the youngest age group (aged 59 years or younger) with American Journal Committee on Cancer (AJCC) stage IV RCC. The highest other-cause (OCM) rate (33%) at five years was observed in the oldest age group (age 80 years and older) with AJCC stage I RCC. CMS rates increased with disease stage, whereas OCM rates increased with age.
Similar trends were observed among patients with high-grade tumors, where the highest CSM rate (79%) at five years was observed in the youngest age group with AJCC stage IV RCC, whereas the highest OCM rate (44%) at five years was found in the oldest age group with AJCC stage I RCC.
The researchers, led by Marco Bianchi, MD, a research fellow at the University of Montreal and a resident at Vita-Salute San Raffaele University in Milan, said it is noteworthy that tumor grade was not especially detrimental among patients with AJCC stage I RCC, particularly in the elderly. For example, the authors stated, the five CSM rate in patients aged 80 years or younger with AJCC stage I RCC was 7% for low-grade versus 8% for high-grade disease. In contrast, for the same stage, the five-year CSM rate for patients aged 59 years or younger was 2% for low-grade disease compared with 6% for high-grade disease.