Better overall and cancer-specific survival for patients under age 40.


Renal cell carcinoma (RCC) diagnosed in patients at a younger age has more favorable histopathologic features and survival compared with RCC diagnosed in older patients, according to researchers.

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They studied 4,774 patients who underwent surgery for RCC. The investigators divided subjects into four age categories: 40 years and younger; older than 40 but younger than 60; 60 and older but younger than 80; and 80 and older.


The proportion of patients with stage T1-T2 tumors decreased significantly with increasing age (77.8%, 66.3%, 57.8%, and 55.4% of patients, respectively). The five-year overall and cancer-specific survival rate also declined significantly with increasing age (82%, 71%, 61%, and 49%, respectively, and 85%, 74%, 70%, and 69%, respectively).


The researchers, led by Jean-Jacques Patard, MD, of Rennes University Hospital in Rennes, France, reported their findings in European Urology (2007;51:1298-1305). Patients aged 40 and younger were more likely to have chromophobe or papillary malignancies and less likely to have clear-cell RCC. N stage did not differ among the groups. The 40-and-younger group also had a higher proportion of women than the older groups (44.8% vs. 29%, 34.8%, and 39.2%, respectively).


In addition, the 40-and-younger group and the 80-and-older group were the most likely patients to be symptomatic at diagnosis (54.5% and 58.7% of patients, respectively). The proportions were 51.4% and 47.1% for patients older than 40 but younger than 60 and those aged 60 and older but younger than 80.


In an accompanying editorial, Scott E. Eggener, of MemorialSloan-KetteringCancerCenter in New York, said the new study “provides timely and interesting clinicopathologic insights.” Dr. Patard and his colleagues “convincingly validate previous studies” and demonstrate that younger patients with surgically treated RCC are more likely to be female, describe symptoms at diagnosis, have organ-confined disease, have non-clear-cell histologies, and be cured of their disease following surgery, Dr. Eggener wrote.