Luigi Nocera1, Claudia Collà Ruvolo2, Lara F Stolzenbach3, Mike Wenzel4, Zhe Tian5, Alessandro Larcher6, Umberto Capitanio6, Vincenzo Mirone7, Derya Tilki8, Felix K H Chun9, Anil Kapoor10, Shahrokh F Shariat11, Fred Saad5, Francesco Montorsi6, Alberto Briganti6, Pierre I Karakiewicz5. 1. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Canada; Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy. Electronic address: nocera.luigi@hsr.it. 2. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Canada; Department of Urology, University of Naples Federico II, Naples, Italy. 3. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Canada; Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 4. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Canada; Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany. 5. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Canada. 6. Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy. 7. Department of Urology, University of Naples Federico II, Naples, Italy. 8. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 9. Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany. 10. Division of Urology, Department of Surgery, Juravinski Cancer Centre, McMaster University, Hamilton, Canada. 11. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Departments of Urology, Weill Cornell Medical College, New York, NY, USA; Department of Urology, University of Texas Southwestern, Dallas, TX, USA; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan.
Abstract
BACKGROUND: For patients with nonmetastatic renal cell carcinoma (nmRCC) treated with nephrectomy, prediction of cancer-specific mortality (CSM) by T stage and substage has not been validated for the separate histological subtypes. OBJECTIVE: To investigate the ability of pathological T stage and substage to predict CSM for patients with clear-cell, papillary, or chromophobe nmRCC treated with nephrectomy. DESIGN, SETTING, AND PARTICIPANTS: Using the SEER database for 2004-2016, we identified 87 149 patients with T1-4 N0/X M0 nmRCC treated with nephrectomy for the clear-cell (65 715; 75.4%), papillary (14 587; 16.7%), or chromophobe (6847; 7.9%) histological subtype. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Kaplan-Meier plots and Cox regression models were used to estimate CSM. RESULTS AND LIMITATIONS: For all three histological subtypes, patients with T1a-T3a disease exhibited more favorable CSM than patients with T3b-T4 RCC. For clear-cell RCC, there were clinically meaningful and statistically significant differences for virtually all intergroup comparisons among T1a-T3a stages. For papillary T1a-T3a RCC, clinically meaningful differences disappeared, although the statistical significance remained. For chromophobe T1a-T3a RCC, no clinically meaningful or statistically significant differences were observed. For all three histological subtypes, patients with T3b-T4 RCC exhibited virtually uniformly unfavorable CSM, with no clinically meaningful intergroup CSM differences. CONCLUSION: The use of T stage and substage for stratification of patients with nmRCC treated with nephrectomy revealed differences in CSM among T1a-T3a cases, but not T3b-T4. The magnitude of the CSM difference was greatest for clear-cell, intermediate for papillary, and marginal for chromophobe RCC. PATIENT SUMMARY: For patients with kidney cancer, the stage of their disease assessed after surgery on the affected kidney can predict how likely they are to die from their cancer. This prediction varies for different subtypes of kidney cancer.
BACKGROUND: For patients with nonmetastatic renal cell carcinoma (nmRCC) treated with nephrectomy, prediction of cancer-specific mortality (CSM) by T stage and substage has not been validated for the separate histological subtypes. OBJECTIVE: To investigate the ability of pathological T stage and substage to predict CSM for patients with clear-cell, papillary, or chromophobe nmRCC treated with nephrectomy. DESIGN, SETTING, AND PARTICIPANTS: Using the SEER database for 2004-2016, we identified 87 149 patients with T1-4 N0/X M0 nmRCC treated with nephrectomy for the clear-cell (65 715; 75.4%), papillary (14 587; 16.7%), or chromophobe (6847; 7.9%) histological subtype. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Kaplan-Meier plots and Cox regression models were used to estimate CSM. RESULTS AND LIMITATIONS: For all three histological subtypes, patients with T1a-T3a disease exhibited more favorable CSM than patients with T3b-T4 RCC. For clear-cell RCC, there were clinically meaningful and statistically significant differences for virtually all intergroup comparisons among T1a-T3a stages. For papillary T1a-T3a RCC, clinically meaningful differences disappeared, although the statistical significance remained. For chromophobe T1a-T3a RCC, no clinically meaningful or statistically significant differences were observed. For all three histological subtypes, patients with T3b-T4 RCC exhibited virtually uniformly unfavorable CSM, with no clinically meaningful intergroup CSM differences. CONCLUSION: The use of T stage and substage for stratification of patients with nmRCC treated with nephrectomy revealed differences in CSM among T1a-T3a cases, but not T3b-T4. The magnitude of the CSM difference was greatest for clear-cell, intermediate for papillary, and marginal for chromophobe RCC. PATIENT SUMMARY: For patients with kidney cancer, the stage of their disease assessed after surgery on the affected kidney can predict how likely they are to die from their cancer. This prediction varies for different subtypes of kidney cancer.
Authors: Luigi Nocera; Giuseppe Fallara; Daniele Raggi; Federico Belladelli; Daniele Robesti; Francesco Montorsi; Pierre I Karakiewicz; Bernard Malavaud; Guillaume Ploussard; Andrea Necchi; Alberto Martini Journal: Front Oncol Date: 2022-09-05 Impact factor: 5.738
Authors: Mike Wenzel; Nicolas Siron; Claudia Collà Ruvolo; Luigi Nocera; Christoph Würnschimmel; Zhe Tian; Shahrokh F Shariat; Fred Saad; Alberto Briganti; Derya Tilki; Severine Banek; Luis A Kluth; Frederik C Roos; Felix K H Chun; Pierre I Karakiewicz Journal: Cancer Causes Control Date: 2021-09-02 Impact factor: 2.506
Authors: Mike Wenzel; Hang Yu; Annemarie Uhlig; Christoph Würnschimmel; Manuel Wallbach; Andreas Becker; Margit Fisch; Felix K H Chun; Christian P Meyer; Marianne Leitsmann Journal: Int Urol Nephrol Date: 2021-07-16 Impact factor: 2.370