Differences in Overall and Cancer-specific Survival of Patients Presenting With Chromophobe Versus Clear Cell Renal Cell Carcinoma: A Propensity Score Matched Analysis
Autor: | C. Ziesel, Frederik C. Roos, Andreas Neisius, Wolfgang Jäger, Mohammed M Kamal, Walburgis Brenner, Christian Thomas, Joachim W. Thüroff, Lisa Knoechlein, Sebastian Frees, Robert H. Bell |
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Rok vydání: | 2016 |
Předmět: |
Male
Oncology medicine.medical_specialty Urology Chromophobe Renal Cell Carcinoma 030232 urology & nephrology Chromophobe cell 03 medical and health sciences 0302 clinical medicine Germany Internal medicine medicine Carcinoma Humans Propensity Score Carcinoma Renal Cell Survival analysis Aged Neoplasm Staging Retrospective Studies Proportional hazards model business.industry Retrospective cohort study Middle Aged Prognosis medicine.disease Survival Analysis Kidney Neoplasms Surgery Survival Rate Clear cell renal cell carcinoma 030220 oncology & carcinogenesis Propensity score matching Female business Follow-Up Studies Forecasting |
Zdroj: | Urology. 98:81-87 |
ISSN: | 0090-4295 |
Popis: | To investigate prognostic parameters for the oncological outcome of patients treated for chromophobe renal cell carcinoma (chRCC) in comparison with patients treated for clear cell RCC (ccRCC) using propensity score matching for survival analysis.From 1969 to 2009, we identified 1010 from 3567 patients with RCC. Survival was analyzed using Kaplan-Meier estimate for histological subtypes including 109 chRCC and 901 ccRCC. Uni- and multivariate Cox regression was used to analyze prognostic factors for overall survival (OS) and cancer-specific survival (CSS). Propensity score matching was performed to adjust for differences in patient characteristics among histological subgroups.The median follow-up was 61 months (range 0-289). chRCC showed longer OS (5 year, 90.1%; 10 year, 74.2%; 15 year, 61.4%) and CSS (94.2%, 89.7%, 89.7%) compared with ccRCC (OS 75.7%, 54.9%, 46.1% and CSS 84.7%, 75.4%, 72.2%; P = .002). Multivariate Cox regression revealed histology as a significant prognostic factor. Propensity score matching showed a difference in 72.4% (OS) and 87.2% (CSS) of matching attempts confirming the significant impact of histology. Univariate Cox regression showed nephron sparing surgery, no metastasis and no symptoms at presentation, age65, eosinophilic features, low American Society of Anesthesiologists score, and Charlson Comorbidity Index to be beneficial for CSS. Only age at surgery, metastasis at presentation, and American Society of Anesthesiologists and Charlson Comorbidity Index scores were significant factors for OS in chRCC patients.ChRCC appears to have a favorable outcome compared with ccRCC. Even after adjustment for differences in characteristics known to have an influence on survival by propensity score matching, histology remains a significant prognostic factor. |
Databáze: | OpenAIRE |
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