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Cancer-specific Mortality in T1a Renal Cell Carcinoma Treated with Local Tumor Destruction Versus Partial Nephrectomy

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Cancer-specific Mortality in T1a Renal Cell Carcinoma Treated with Local Tumor Destruction Versus Partial Nephrectomy. / Sorce, Gabriele; Hoeh, Benedikt; Hohenhorst, Lukas; Panunzio, Andrea; Tappero, Stefano; Tian, Zhe; Kokorovic, Andrea; Larcher, Alessandro; Capitanio, Umberto; Tilki, Derya; Terrone, Carlo; Chun, Felix K H; Antonelli, Alessandro; Saad, Fred; Shariat, Shahrokh F; Montorsi, Francesco; Briganti, Alberto; Karakiewicz, Pierre I.

In: EUR UROL FOCUS, Vol. 9, No. 1, 01.2023, p. 125-132.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Sorce, G, Hoeh, B, Hohenhorst, L, Panunzio, A, Tappero, S, Tian, Z, Kokorovic, A, Larcher, A, Capitanio, U, Tilki, D, Terrone, C, Chun, FKH, Antonelli, A, Saad, F, Shariat, SF, Montorsi, F, Briganti, A & Karakiewicz, PI 2023, 'Cancer-specific Mortality in T1a Renal Cell Carcinoma Treated with Local Tumor Destruction Versus Partial Nephrectomy', EUR UROL FOCUS, vol. 9, no. 1, pp. 125-132. https://doi.org/10.1016/j.euf.2022.07.005

APA

Sorce, G., Hoeh, B., Hohenhorst, L., Panunzio, A., Tappero, S., Tian, Z., Kokorovic, A., Larcher, A., Capitanio, U., Tilki, D., Terrone, C., Chun, F. K. H., Antonelli, A., Saad, F., Shariat, S. F., Montorsi, F., Briganti, A., & Karakiewicz, P. I. (2023). Cancer-specific Mortality in T1a Renal Cell Carcinoma Treated with Local Tumor Destruction Versus Partial Nephrectomy. EUR UROL FOCUS, 9(1), 125-132. https://doi.org/10.1016/j.euf.2022.07.005

Vancouver

Sorce G, Hoeh B, Hohenhorst L, Panunzio A, Tappero S, Tian Z et al. Cancer-specific Mortality in T1a Renal Cell Carcinoma Treated with Local Tumor Destruction Versus Partial Nephrectomy. EUR UROL FOCUS. 2023 Jan;9(1):125-132. https://doi.org/10.1016/j.euf.2022.07.005

Bibtex

@article{73abeee571f54db082fae845e006e456,
title = "Cancer-specific Mortality in T1a Renal Cell Carcinoma Treated with Local Tumor Destruction Versus Partial Nephrectomy",
abstract = "BACKGROUND: Large-scale analyses addressing cancer-specific mortality (CSM) in T1a renal cell carcinoma (RCC) patients treated with local tumor destruction (LTD), relative to partial nephrectomy (PN), are scarce.OBJECTIVE: To compare CSM after LTD versus PN.DESIGN, SETTING, AND PARTICIPANTS: Within the Surveillance, Epidemiology, and End Results (SEER) database (2004-2018), we identified patients with clinical T1a stage RCC treated with LTD or PN.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSES: After 1:1 ratio propensity score matching (PSM) between patients treated with LTD versus PN, competing risks regression (CRR) models addressed CSM, after adjustment for other-cause mortality (OCM) and other covariates (age, tumor size, tumor grade, and histological subtype).RESULTS AND LIMITATIONS: Relative to the 35 984 PN patients, 5936 LTD patients were older and more frequently harbored unknown RCC histological subtype or unknown grade. After 1:1 PSM that resulted in 5352 LTD versus 5352 PN patients, the 10-yr CSM rate was 8.7% versus 5.5%. In multivariable CRR models, LTD was associated with higher CSM, relative to PN (hazard ratio [HR]: 1.58, p < 0.001). Subgroup analyses revealed invariably higher CSM after LTD versus PN in patients with tumor size ≤3 cm (10-yr CSM 7.2% vs 5.3%, multivariable HR: 1.47, p < 0.001) and in patients with tumor size 3.1-4 cm (10-yr CSM 11.4% vs 6.1%, multivariable HR: 1.72, p < 0.001). Lack of information regarding earlier cancer controls, retreatment, tumor location within the kidney, and type of surgery represented limitations.CONCLUSIONS: In T1a RCC patients, LTD is invariably associated with higher CSM relative to PN, even after adjustment for OCM and all available patient and tumor characteristics, and regardless of tumor size considerations. However, the magnitude of CSM disadvantage was more pronounced in LTD patients with tumor size 3.1-4 cm than in those with tumor size ≤3 cm.PATIENT SUMMARY: In patients with small renal masses, we observed higher cancer-specific death rates for local tumor destruction (LTD) than for partial nephrectomy. The LTD disadvantage was more pronounced for patients with tumor size 3.1-4 cm, but was also present in those with tumor size ≤3 cm.",
keywords = "Humans, Carcinoma, Renal Cell/pathology, Kidney Neoplasms/pathology, Nephrectomy/methods, Kidney/surgery, Proportional Hazards Models",
author = "Gabriele Sorce and Benedikt Hoeh and Lukas Hohenhorst and Andrea Panunzio and Stefano Tappero and Zhe Tian and Andrea Kokorovic and Alessandro Larcher and Umberto Capitanio and Derya Tilki and Carlo Terrone and Chun, {Felix K H} and Alessandro Antonelli and Fred Saad and Shariat, {Shahrokh F} and Francesco Montorsi and Alberto Briganti and Karakiewicz, {Pierre I}",
note = "Copyright {\textcopyright} 2022 European Association of Urology. Published by Elsevier B.V. All rights reserved.",
year = "2023",
month = jan,
doi = "10.1016/j.euf.2022.07.005",
language = "English",
volume = "9",
pages = "125--132",
journal = "EUR UROL FOCUS",
issn = "2405-4569",
publisher = "Elsevier BV",
number = "1",

}

RIS

TY - JOUR

T1 - Cancer-specific Mortality in T1a Renal Cell Carcinoma Treated with Local Tumor Destruction Versus Partial Nephrectomy

AU - Sorce, Gabriele

AU - Hoeh, Benedikt

AU - Hohenhorst, Lukas

AU - Panunzio, Andrea

AU - Tappero, Stefano

AU - Tian, Zhe

AU - Kokorovic, Andrea

AU - Larcher, Alessandro

AU - Capitanio, Umberto

AU - Tilki, Derya

AU - Terrone, Carlo

AU - Chun, Felix K H

AU - Antonelli, Alessandro

AU - Saad, Fred

AU - Shariat, Shahrokh F

AU - Montorsi, Francesco

AU - Briganti, Alberto

AU - Karakiewicz, Pierre I

N1 - Copyright © 2022 European Association of Urology. Published by Elsevier B.V. All rights reserved.

PY - 2023/1

Y1 - 2023/1

N2 - BACKGROUND: Large-scale analyses addressing cancer-specific mortality (CSM) in T1a renal cell carcinoma (RCC) patients treated with local tumor destruction (LTD), relative to partial nephrectomy (PN), are scarce.OBJECTIVE: To compare CSM after LTD versus PN.DESIGN, SETTING, AND PARTICIPANTS: Within the Surveillance, Epidemiology, and End Results (SEER) database (2004-2018), we identified patients with clinical T1a stage RCC treated with LTD or PN.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSES: After 1:1 ratio propensity score matching (PSM) between patients treated with LTD versus PN, competing risks regression (CRR) models addressed CSM, after adjustment for other-cause mortality (OCM) and other covariates (age, tumor size, tumor grade, and histological subtype).RESULTS AND LIMITATIONS: Relative to the 35 984 PN patients, 5936 LTD patients were older and more frequently harbored unknown RCC histological subtype or unknown grade. After 1:1 PSM that resulted in 5352 LTD versus 5352 PN patients, the 10-yr CSM rate was 8.7% versus 5.5%. In multivariable CRR models, LTD was associated with higher CSM, relative to PN (hazard ratio [HR]: 1.58, p < 0.001). Subgroup analyses revealed invariably higher CSM after LTD versus PN in patients with tumor size ≤3 cm (10-yr CSM 7.2% vs 5.3%, multivariable HR: 1.47, p < 0.001) and in patients with tumor size 3.1-4 cm (10-yr CSM 11.4% vs 6.1%, multivariable HR: 1.72, p < 0.001). Lack of information regarding earlier cancer controls, retreatment, tumor location within the kidney, and type of surgery represented limitations.CONCLUSIONS: In T1a RCC patients, LTD is invariably associated with higher CSM relative to PN, even after adjustment for OCM and all available patient and tumor characteristics, and regardless of tumor size considerations. However, the magnitude of CSM disadvantage was more pronounced in LTD patients with tumor size 3.1-4 cm than in those with tumor size ≤3 cm.PATIENT SUMMARY: In patients with small renal masses, we observed higher cancer-specific death rates for local tumor destruction (LTD) than for partial nephrectomy. The LTD disadvantage was more pronounced for patients with tumor size 3.1-4 cm, but was also present in those with tumor size ≤3 cm.

AB - BACKGROUND: Large-scale analyses addressing cancer-specific mortality (CSM) in T1a renal cell carcinoma (RCC) patients treated with local tumor destruction (LTD), relative to partial nephrectomy (PN), are scarce.OBJECTIVE: To compare CSM after LTD versus PN.DESIGN, SETTING, AND PARTICIPANTS: Within the Surveillance, Epidemiology, and End Results (SEER) database (2004-2018), we identified patients with clinical T1a stage RCC treated with LTD or PN.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSES: After 1:1 ratio propensity score matching (PSM) between patients treated with LTD versus PN, competing risks regression (CRR) models addressed CSM, after adjustment for other-cause mortality (OCM) and other covariates (age, tumor size, tumor grade, and histological subtype).RESULTS AND LIMITATIONS: Relative to the 35 984 PN patients, 5936 LTD patients were older and more frequently harbored unknown RCC histological subtype or unknown grade. After 1:1 PSM that resulted in 5352 LTD versus 5352 PN patients, the 10-yr CSM rate was 8.7% versus 5.5%. In multivariable CRR models, LTD was associated with higher CSM, relative to PN (hazard ratio [HR]: 1.58, p < 0.001). Subgroup analyses revealed invariably higher CSM after LTD versus PN in patients with tumor size ≤3 cm (10-yr CSM 7.2% vs 5.3%, multivariable HR: 1.47, p < 0.001) and in patients with tumor size 3.1-4 cm (10-yr CSM 11.4% vs 6.1%, multivariable HR: 1.72, p < 0.001). Lack of information regarding earlier cancer controls, retreatment, tumor location within the kidney, and type of surgery represented limitations.CONCLUSIONS: In T1a RCC patients, LTD is invariably associated with higher CSM relative to PN, even after adjustment for OCM and all available patient and tumor characteristics, and regardless of tumor size considerations. However, the magnitude of CSM disadvantage was more pronounced in LTD patients with tumor size 3.1-4 cm than in those with tumor size ≤3 cm.PATIENT SUMMARY: In patients with small renal masses, we observed higher cancer-specific death rates for local tumor destruction (LTD) than for partial nephrectomy. The LTD disadvantage was more pronounced for patients with tumor size 3.1-4 cm, but was also present in those with tumor size ≤3 cm.

KW - Humans

KW - Carcinoma, Renal Cell/pathology

KW - Kidney Neoplasms/pathology

KW - Nephrectomy/methods

KW - Kidney/surgery

KW - Proportional Hazards Models

U2 - 10.1016/j.euf.2022.07.005

DO - 10.1016/j.euf.2022.07.005

M3 - SCORING: Journal article

C2 - 35918270

VL - 9

SP - 125

EP - 132

JO - EUR UROL FOCUS

JF - EUR UROL FOCUS

SN - 2405-4569

IS - 1

ER -