Korean J Urol.  2012 Jan;53(1):18-22. 10.4111/kju.2012.53.1.18.

Predicting Factors for Death from Other Causes in Patients with Localized Renal Cell Carcinoma

• Chang JS
• Park YH
• Ku JH
• Kwak C
• Kim HH

• KMID: 1988818
• DOI: http://doi.org/10.4111/kju.2012.53.1.18

Abstract

PURPOSE
To identify the predictors of death from other causes in patients with localized renal cell carcinoma (RCC).
MATERIALS AND METHODS
We identified 1,101 patients with pathologically confirmed T1 or T2 RCC with a follow-up duration of over 6 months. Survival according to the cause of death was evaluated by using the Kaplan-Meier analysis with log-rank test. Prognostic factors for death from other causes were assessed by multivariate analysis using the Cox proportional hazard regression model. Once the prognostic factors were identified, a risk-group variable was created by counting the number of unfavorable features present for each patient.
RESULTS
The median follow-up was 62 months, and RCC-related death occurred in 50 patients (4.5%), whereas death from other causes occurred in 47 (4.3%). Patients who died from other causes had a higher American Society of Anesthesiologist (ASA) score (26.1% vs. 10.2%; p=0.044), older age (63.4 years vs. 55.0 years; p<0.001), smaller mass size (5.1 cm vs. 7.9 cm; p<0.001), and lower nuclear grade (p=0.003). In the multivariate Cox regression analysis, older age, higher ASA score, and lower body mass index were independent factors predicting death from other causes in patients with localized RCC. On the basis of the number of risk factors for death from other causes, the 5-year other-cause-specific survival was 98.3% (0 risk factors), 84.7% (1 risk factor), and 67.6% (2 or 3 risk factors), respectively (p<0.001).
CONCLUSIONS
Older age, higher ASA score, and lower body mass index were independent predictors of death from other causes in patients with localized RCC.

Keyword

Mortality; Renal cell carcinoma; Watchful waiting

MeSH Terms

Body Mass Index
Carcinoma, Renal Cell
Cause of Death
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Multivariate Analysis
Risk Factors
Watchful Waiting

Figure

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  FIG. 1 Cumulative incidence of death by cause (RCC vs. other cause).

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  FIG. 2 Other-cause-specific survival according to (A) age at diagnosis, (B) BMI, and (C) ASA score.

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  FIG. 3 Other-cause-specific survival according to the number of risk factors.

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