Overall survival and renal function after partial and radical nephrectomy among older patients with localised renal cell carcinoma

A propensity-matched multicentre study

Jae Seung Chung, Nak Hoon Son, Sang Eun Lee, Sung Kyu Hong, Sang Chul Lee, Cheol Kwak, Sung Hoo Hong, Yong June Kim, Seok Ho Kang, Seok Soo Byun

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background This study aimed to evaluate the overall survival (OS) rate and renal function after radical nephrectomy (RN) and partial nephrectomy (PN) in patients aged ≥65 years. Methods Patients who underwent RN (n = 622) or PN (n = 622) for renal cell carcinoma (pT1N0M0) between 1999 and 2011 were propensity-score matched in our multicentre database. To investigate the relative effect of PN on OS according to age, we divided the patients into two age subgroups (<65 and ≥65 years). The 5-year OS rates and probabilities of freedom from chronic kidney disease (CKD III or IV) were estimated using the Kaplan-Meier method and separate Cox proportional hazards models. Results The 5-year OS rates after surgery were 94.7% for PN and 91.9% for RN in the older patients (P = 0.698). The corresponding rates in the younger patients were 99.7% for PN and 96.3% for RN (P = 0.015). In separate Cox hazards models for OS, the older patients who underwent PN were not significantly different from their RN-treated counterparts (hazard ratio (HR): 0.960; 95% confidence interval (CI): 0.277-2.321, P = 0.797). Kidney function was significantly better preserved after PN than after RN at all ages. However, stage IV CKD in the older patients did not occur more frequently in the RN arm than in the PN arm. Conclusions Although PN was associated with improved renal function compared with RN, it did not confer a benefit of higher survival rate in elderly patients (≥65 years old).

Original languageEnglish
Pages (from-to)489-497
Number of pages9
JournalEuropean Journal of Cancer
Volume51
Issue number4
DOIs
Publication statusPublished - 2015 Jan 1

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Nephrectomy
Renal Cell Carcinoma
Multicenter Studies
Kidney
Survival
Survival Rate
Proportional Hazards Models
Propensity Score
Chronic Renal Insufficiency

Keywords

  • Nephrectomy
  • Propensity score
  • Renal cell carcinoma
  • Renal insufficiency
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Overall survival and renal function after partial and radical nephrectomy among older patients with localised renal cell carcinoma : A propensity-matched multicentre study. / Chung, Jae Seung; Son, Nak Hoon; Lee, Sang Eun; Hong, Sung Kyu; Lee, Sang Chul; Kwak, Cheol; Hong, Sung Hoo; Kim, Yong June; Kang, Seok Ho; Byun, Seok Soo.

In: European Journal of Cancer, Vol. 51, No. 4, 01.01.2015, p. 489-497.

Research output: Contribution to journalArticle

Chung, Jae Seung ; Son, Nak Hoon ; Lee, Sang Eun ; Hong, Sung Kyu ; Lee, Sang Chul ; Kwak, Cheol ; Hong, Sung Hoo ; Kim, Yong June ; Kang, Seok Ho ; Byun, Seok Soo. / Overall survival and renal function after partial and radical nephrectomy among older patients with localised renal cell carcinoma : A propensity-matched multicentre study. In: European Journal of Cancer. 2015 ; Vol. 51, No. 4. pp. 489-497.
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abstract = "Background This study aimed to evaluate the overall survival (OS) rate and renal function after radical nephrectomy (RN) and partial nephrectomy (PN) in patients aged ≥65 years. Methods Patients who underwent RN (n = 622) or PN (n = 622) for renal cell carcinoma (pT1N0M0) between 1999 and 2011 were propensity-score matched in our multicentre database. To investigate the relative effect of PN on OS according to age, we divided the patients into two age subgroups (<65 and ≥65 years). The 5-year OS rates and probabilities of freedom from chronic kidney disease (CKD III or IV) were estimated using the Kaplan-Meier method and separate Cox proportional hazards models. Results The 5-year OS rates after surgery were 94.7{\%} for PN and 91.9{\%} for RN in the older patients (P = 0.698). The corresponding rates in the younger patients were 99.7{\%} for PN and 96.3{\%} for RN (P = 0.015). In separate Cox hazards models for OS, the older patients who underwent PN were not significantly different from their RN-treated counterparts (hazard ratio (HR): 0.960; 95{\%} confidence interval (CI): 0.277-2.321, P = 0.797). Kidney function was significantly better preserved after PN than after RN at all ages. However, stage IV CKD in the older patients did not occur more frequently in the RN arm than in the PN arm. Conclusions Although PN was associated with improved renal function compared with RN, it did not confer a benefit of higher survival rate in elderly patients (≥65 years old).",
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T1 - Overall survival and renal function after partial and radical nephrectomy among older patients with localised renal cell carcinoma

T2 - A propensity-matched multicentre study

AU - Chung, Jae Seung

AU - Son, Nak Hoon

AU - Lee, Sang Eun

AU - Hong, Sung Kyu

AU - Lee, Sang Chul

AU - Kwak, Cheol

AU - Hong, Sung Hoo

AU - Kim, Yong June

AU - Kang, Seok Ho

AU - Byun, Seok Soo

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Background This study aimed to evaluate the overall survival (OS) rate and renal function after radical nephrectomy (RN) and partial nephrectomy (PN) in patients aged ≥65 years. Methods Patients who underwent RN (n = 622) or PN (n = 622) for renal cell carcinoma (pT1N0M0) between 1999 and 2011 were propensity-score matched in our multicentre database. To investigate the relative effect of PN on OS according to age, we divided the patients into two age subgroups (<65 and ≥65 years). The 5-year OS rates and probabilities of freedom from chronic kidney disease (CKD III or IV) were estimated using the Kaplan-Meier method and separate Cox proportional hazards models. Results The 5-year OS rates after surgery were 94.7% for PN and 91.9% for RN in the older patients (P = 0.698). The corresponding rates in the younger patients were 99.7% for PN and 96.3% for RN (P = 0.015). In separate Cox hazards models for OS, the older patients who underwent PN were not significantly different from their RN-treated counterparts (hazard ratio (HR): 0.960; 95% confidence interval (CI): 0.277-2.321, P = 0.797). Kidney function was significantly better preserved after PN than after RN at all ages. However, stage IV CKD in the older patients did not occur more frequently in the RN arm than in the PN arm. Conclusions Although PN was associated with improved renal function compared with RN, it did not confer a benefit of higher survival rate in elderly patients (≥65 years old).

AB - Background This study aimed to evaluate the overall survival (OS) rate and renal function after radical nephrectomy (RN) and partial nephrectomy (PN) in patients aged ≥65 years. Methods Patients who underwent RN (n = 622) or PN (n = 622) for renal cell carcinoma (pT1N0M0) between 1999 and 2011 were propensity-score matched in our multicentre database. To investigate the relative effect of PN on OS according to age, we divided the patients into two age subgroups (<65 and ≥65 years). The 5-year OS rates and probabilities of freedom from chronic kidney disease (CKD III or IV) were estimated using the Kaplan-Meier method and separate Cox proportional hazards models. Results The 5-year OS rates after surgery were 94.7% for PN and 91.9% for RN in the older patients (P = 0.698). The corresponding rates in the younger patients were 99.7% for PN and 96.3% for RN (P = 0.015). In separate Cox hazards models for OS, the older patients who underwent PN were not significantly different from their RN-treated counterparts (hazard ratio (HR): 0.960; 95% confidence interval (CI): 0.277-2.321, P = 0.797). Kidney function was significantly better preserved after PN than after RN at all ages. However, stage IV CKD in the older patients did not occur more frequently in the RN arm than in the PN arm. Conclusions Although PN was associated with improved renal function compared with RN, it did not confer a benefit of higher survival rate in elderly patients (≥65 years old).

KW - Nephrectomy

KW - Propensity score

KW - Renal cell carcinoma

KW - Renal insufficiency

KW - Survival

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JO - European Journal of Cancer

JF - European Journal of Cancer

SN - 0959-8049

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