Delay in nephrectomy and cancer control outcomes in elderly patients with small renal masses
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Delay in nephrectomy and cancer control outcomes in elderly patients with small renal masses. / Becker, Andreas; Roghmann, Florian; Ravi, Praful; Tian, Zhe; Kluth, Luis Alexander; Gandaglia, Giorgio; Noldus, Joachim; Dahlem, Roland; Schlomm, Thorsten; Graefen, Markus; Karakiewicz, Pierre I; Trinh, Quoc-Dien; Sun, Maxine.
in: UROL INT, Jahrgang 92, Nr. 4, 01.01.2014, S. 455-461.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Delay in nephrectomy and cancer control outcomes in elderly patients with small renal masses
AU - Becker, Andreas
AU - Roghmann, Florian
AU - Ravi, Praful
AU - Tian, Zhe
AU - Kluth, Luis Alexander
AU - Gandaglia, Giorgio
AU - Noldus, Joachim
AU - Dahlem, Roland
AU - Schlomm, Thorsten
AU - Graefen, Markus
AU - Karakiewicz, Pierre I
AU - Trinh, Quoc-Dien
AU - Sun, Maxine
PY - 2014/1/1
Y1 - 2014/1/1
N2 - Objective: To examine the impact of nephrectomy delay on the survival of patients with small renal masses. Methods: Relying on the Surveillance, Epidemiology, and End Results Medicare-linked database, 6,237 patients with pT1a renal cell carcinoma who underwent radical or partial nephrectomy were identified (1988-2005). Nephrectomy delay was dichotomized as ≤3 vs. >3 months. Uni- and multivariate Cox regression analyses tested the effect of delayed nephrectomy on cancer-specific mortality (CSM). In sub-analyses, various other time from diagnosis to nephrectomy cut-offs were modelled: (a) ≤1 vs. >1 month, (b) ≤2 vs. >2 months, (c) ≤4 vs. >4 months, (d) ≤6 vs. >6 months, (e) ≤12 vs. >12 months or (f) continuously coded. Results: In univariate analyses, nephrectomy delay >3 months was associated with a higher risk of CSM (hazard ratio [HR]: 2.07; 95% confidence interval [CI]: 1.58-2.72; p < 0.001). However, after multivariate adjustment, a nephrectomy delay >3 months was not significantly associated with a higher risk of CSM (HR: 1.33; 95% CI: 0.96-1.86; p = 0.09). The lack of a relationship between nephrectomy delay and CSM after multivariate adjustment persisted even in various sub-analyses of other categorizations for nephrectomy delay. Conclusions: In the case of eventual nephrectomy delay among patients with small renal masses, CSM is unaffected. © 2014 S. Karger AG, Basel.
AB - Objective: To examine the impact of nephrectomy delay on the survival of patients with small renal masses. Methods: Relying on the Surveillance, Epidemiology, and End Results Medicare-linked database, 6,237 patients with pT1a renal cell carcinoma who underwent radical or partial nephrectomy were identified (1988-2005). Nephrectomy delay was dichotomized as ≤3 vs. >3 months. Uni- and multivariate Cox regression analyses tested the effect of delayed nephrectomy on cancer-specific mortality (CSM). In sub-analyses, various other time from diagnosis to nephrectomy cut-offs were modelled: (a) ≤1 vs. >1 month, (b) ≤2 vs. >2 months, (c) ≤4 vs. >4 months, (d) ≤6 vs. >6 months, (e) ≤12 vs. >12 months or (f) continuously coded. Results: In univariate analyses, nephrectomy delay >3 months was associated with a higher risk of CSM (hazard ratio [HR]: 2.07; 95% confidence interval [CI]: 1.58-2.72; p < 0.001). However, after multivariate adjustment, a nephrectomy delay >3 months was not significantly associated with a higher risk of CSM (HR: 1.33; 95% CI: 0.96-1.86; p = 0.09). The lack of a relationship between nephrectomy delay and CSM after multivariate adjustment persisted even in various sub-analyses of other categorizations for nephrectomy delay. Conclusions: In the case of eventual nephrectomy delay among patients with small renal masses, CSM is unaffected. © 2014 S. Karger AG, Basel.
U2 - 10.1159/000356175
DO - 10.1159/000356175
M3 - SCORING: Journal article
C2 - 24602994
VL - 92
SP - 455
EP - 461
JO - UROL INT
JF - UROL INT
SN - 0042-1138
IS - 4
ER -
