J Korean Med Sci.  2016 Dec;31(12):1976-1982. 10.3346/jkms.2016.31.12.1976.

Impact of Young Age at Diagnosis on Survival in Patients with Surgically Treated Renal Cell Carcinoma: a Multicenter Study

• Kang HW
• Seo SP
• Kim WT
• Yun SJ
• Lee SC
• Kim WJ
• Hwang EC
• Kang SH
• Hong SH
• Chung J
• Kwon TG
• Kim HH
• Kwak C
• Byun SS
• Kim YJ
• KOrean Renal Cell Carcinoma (KORCC) Group

• KMID: 2355628
• DOI: http://doi.org/10.3346/jkms.2016.31.12.1976

Abstract

The prognostic significance of age in renal cell carcinoma (RCC) is a subject of debate. The aim of the present multi-institutional study was to evaluate the impact of age on clinicopathological features and survival in a large cohort of patients with RCC. A total of 5,178 patients who underwent surgery for RCC at eight institutions in Korea between 1999 and 2011 were categorized into three groups according to age at diagnosis as follows: young age (< 40 years, n = 541), middle-age (≥ 40 and < 60 years, n = 2,551), and old age (≥ 60 years, n = 2,096) groups. Clinicopathological variables and survival rates were compared between the three groups. Young patients had lower stage tumors with a low Fuhrman grade, a lower rate of lymphovascular invasion than patients in the other age groups. Regarding histologic type, the young age group had a lower percentage of clear cell histology and a greater incidence of Xp11.2 translocation RCC. Kaplan-Meier estimates showed that cancer-specific survival was significantly better in the young age group than in the other groups (log rank test, P = 0.008). However, age at diagnosis was not an independent predictor of survival in multivariate analysis. In conclusion, young age at diagnosis was associated with favorable pathologic features, although it was not an independent prognostic factor for survival in patients with surgically-treated RCC. Age itself should not be regarded as a crucial determinant for the treatment of RCC.

Keyword

Renal Cell Carcinoma; Nephrectomy; Age; Recurrence; Survival

MeSH Terms

Carcinoma, Renal Cell*
Cohort Studies
Diagnosis*
Humans
Incidence
Korea
Multivariate Analysis
Nephrectomy
Recurrence
Survival Rate

Figure

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  Fig. 1 Kaplan-Meier survival curves. (A) Recurrence-free survival, (B) Cancer-specific survival according to age categories in patients with surgically-treated renal cell carcinoma.

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