Young-Won Kim1, Won Tae Kim1, Seok Joong Yun1, Sang-Cheol Lee1, Wun-Jae Kim1, Yun-Sok Ha2, Yong Hyun Park3, Seok Ho Kang4, Sung-Hoo Hong3, Tae Gyun Kwon2, Seok-Soo Byun5, Cheol Kwak6, Yong-June Kim7. 1. Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, Korea. 2. Department of Urology, Kyungpook National University College of Medicine, Daegu, Korea. 3. Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea. 4. Department of Urology, Korea University School of Medicine, Seoul, Korea. 5. Department of Urology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. 6. Department of Urology, Seoul National University College of Medicine, Seoul, Korea. mdrafael@snu.ac.kr. 7. Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, Korea. urokyj@chungbuk.ac.kr.
Abstract
PURPOSE: Preoperative chronic kidney disease (CKD) status may affect disease outcomes in patients with renal cell carcinoma (RCC). This study evaluated the influence of preoperative CKD status on clinicopathological features and prognosis in patients with RCC. METHODS: Between 1999 and 2011, a total of 1855 patients underwent radical nephrectomy at various centers throughout Korea. Of these patients, 1655 had an estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73 m(2) (non-CKD group) and 200 patients had an eGFR ≥30 but <60 ml/min/1.73 m(2) (CKD group). To reduce the effects of selection bias and potential confounding factors, 600 patients in the non-CKD group were selected by propensity-score matching. RESULTS: The median age of all patients was 57.3 years (range 20-94 years) and the median follow-up was 35.0 months (range 1-154 months). Comparisons of the propensity-score-matched cohorts showed that T and N stages were more advanced and tumor size was larger in the CKD group than in the non-CKD group (p < 0.05 each). Kaplan-Meier analyses showed that recurrence-free survival, cancer-specific survival (CSS), and overall survival (OS) were significantly lower in the CKD group (p < 0.01 each). Multivariate regression analysis showed that preoperative CKD status was an independent predictor of CSS and OS in patients with RCC (p < 0.05 each). CONCLUSIONS: Preoperative CKD may be associated with more aggressive features and poorer prognosis in patients with RCC. RCC patients with preoperative CKD should be carefully and frequently followed-up after nephrectomy.
PURPOSE: Preoperative chronic kidney disease (CKD) status may affect disease outcomes in patients with renal cell carcinoma (RCC). This study evaluated the influence of preoperative CKD status on clinicopathological features and prognosis in patients with RCC. METHODS: Between 1999 and 2011, a total of 1855 patients underwent radical nephrectomy at various centers throughout Korea. Of these patients, 1655 had an estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73 m(2) (non-CKD group) and 200 patients had an eGFR ≥30 but <60 ml/min/1.73 m(2) (CKD group). To reduce the effects of selection bias and potential confounding factors, 600 patients in the non-CKD group were selected by propensity-score matching. RESULTS: The median age of all patients was 57.3 years (range 20-94 years) and the median follow-up was 35.0 months (range 1-154 months). Comparisons of the propensity-score-matched cohorts showed that T and N stages were more advanced and tumor size was larger in the CKD group than in the non-CKD group (p < 0.05 each). Kaplan-Meier analyses showed that recurrence-free survival, cancer-specific survival (CSS), and overall survival (OS) were significantly lower in the CKD group (p < 0.01 each). Multivariate regression analysis showed that preoperative CKD status was an independent predictor of CSS and OS in patients with RCC (p < 0.05 each). CONCLUSIONS: Preoperative CKD may be associated with more aggressive features and poorer prognosis in patients with RCC. RCCpatients with preoperative CKD should be carefully and frequently followed-up after nephrectomy.
Authors: Ho Song Yu; Jun Eul Hwang; Ho Seok Chung; Yang Hyun Cho; Myung Soo Kim; Eu Chang Hwang; Kyung Jin Oh; Sun-Ouck Kim; Seung Il Jung; Taek Won Kang; Dong Deuk Kwon; Kwangsung Park; Soo Bang Ryu; Sung-Hoon Jung; Young Hoe Hur; Joon Hwa Noh; Myung Ki Kim; Ill Young Seo; Chul-Sung Kim; Sung Gu Kang; Seok Ho Kang; Jun Cheon Journal: Oncotarget Date: 2017-03-15