Evaluation of the prognostic role of co-morbidities on disease outcome in renal cell carcinoma patients
Autor: | Allan J. Pantuck, Frank Dombrowski, Shahrokh F. Shariat, Martin Burchardt, Arie S. Belldegrun, Tobias Klatte, Nils Kroeger, Silvia Ribback, Alexandra Drakaki, Johannes Heide |
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Rok vydání: | 2019 |
Předmět: |
Nephrology
Oncology medicine.medical_specialty business.industry Urology 030232 urology & nephrology ECOG Performance Status medicine.disease Lower risk 03 medical and health sciences 0302 clinical medicine Renal cell carcinoma Tumor progression 030220 oncology & carcinogenesis Diabetes mellitus Concomitant Internal medicine medicine business Kidney disease |
Zdroj: | World Journal of Urology. 38:1525-1533 |
ISSN: | 1433-8726 0724-4983 |
DOI: | 10.1007/s00345-019-02930-4 |
Popis: | Co-morbidities may induce local and systemic tumor progression of renal cell carcinoma (RCC); however, the prognostic impact of co-morbidities has not yet been well characterized. RCC patients (n = 2206) surgically treated at three academic institutions in the US and Europe were included in the analysis. Presence of diabetes mellitus, hypertension, chronic kidney disease, chronic obstructive pulmonary disease, coronary heart disease, and hypothyroidism were investigated for their association with clinicopathological features and cancer-specific survival. Hypertension was associated with less advanced T stages (p = 0.025), a lower risk of lymph-node (p = 0.026) and distant metastases (p = 0.001), and improved cancer specific survival in univariable analysis (HR 0.81 95% CI 0.69–0.96, p = 0.013). However, hypertension was not an independent prognostic factor after adjustment for TNM stages, grading, and ECOG performance status (HR 0.95, 95% CI 0.80–1.12; p = 0.530). A correlation between the use of concomitant anti-hypertensive medications and improved survival outcome was not identified. All other investigated co-morbidities did not show significant associations with clinicopathological features or cancer-specific survival. Although the investigated co-morbidities are capable or inducing pathophysiological changes that are predisposing factors for tumor progression, none is an independent prognostic factor in patients with RCC. |
Databáze: | OpenAIRE |
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