Survival improvement over time in renal cell carcinoma treated with nephrectomy: A longitudinal propensity score-matched study.

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology Pub Date : 2024-10-28 DOI:10.1111/iju.15610

Kenjiro Kishitani, Satoru Taguchi, Koji Tanaka, Tetsuya Danno, Takahiro Oshina, Yoichi Fujii, Jun Kamei, Yoshiyuki Akiyama, Shigenori Kakutani, Yusuke Sato, Yuta Yamada, Aya Niimi, Daisuke Yamada, Haruki Kume

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引用次数: 0

Abstract

Objective: Surgical treatment for renal cell carcinoma (RCC) has drastically evolved for the past 30 years. However, survival outcomes of RCC according to times have not been fully elucidated, especially in the real-world setting. This study aimed to assess the survival improvement over time in RCC treated with nephrectomy by analyzing a longitudinal cohort using propensity score matching (PSM).

Methods: We retrospectively reviewed 960 patients with RCC who underwent radical or partial nephrectomy between 1981 and 2018. Patients were divided into two groups according to the time of surgery (1981-1999 vs. 2000-2018). Using PSM, overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) were compared between the two groups.

Results: Overall, 255 and 705 patients underwent surgery in the earlier (1981-1999) and recent (2000-2018) eras, and PSM derived a matched cohort of 466 patients (233 patients per each group). All patients in the earlier era cohort received open surgeries, whereas about a half (47.4%) of patients in the recent era cohort received minimally-invasive (laparoscopic/robotic) surgeries. After PSM, 137 (29.4%) patients developed recurrence, 105 (22.5%) died of RCC, and 113 (24.2%) died from other causes, with a median follow-up period of 90 months. The recent era cohort had significantly longer OS, CSS, and RFS than the earlier era cohort.

Conclusions: Patients with RCC treated in the recent era (2000-2018) showed significantly longer survival than those treated in the earlier era (1981-1999). The improved survival might be attributable to the prevalence of minimally-invasive (laparoscopic/robotic) surgeries.

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肾切除术治疗肾细胞癌的生存率随时间推移而提高：倾向评分匹配纵向研究。

目的：在过去的 30 年中，肾细胞癌（RCC）的手术治疗发生了翻天覆地的变化。然而，RCC 随时间变化的生存结果尚未完全阐明，尤其是在现实世界中。本研究旨在通过使用倾向评分匹配（PSM）分析纵向队列，评估接受肾切除术治疗的 RCC 随时间推移的生存率改善情况：我们回顾性研究了1981年至2018年间接受根治性或部分肾切除术的960例RCC患者。根据手术时间（1981-1999年与2000-2018年）将患者分为两组。使用PSM比较两组患者的总生存期（OS）、癌症特异性生存期（CSS）和无复发生存期（RFS）：总体而言，早期（1981-1999 年）和近期（2000-2018 年）分别有 255 名和 705 名患者接受了手术，PSM 得出了 466 名患者的匹配队列（每组 233 名患者）。早期队列中的所有患者都接受了开腹手术，而近期队列中约有一半（47.4%）的患者接受了微创（腹腔镜/机器人）手术。PSM术后，137例（29.4%）患者复发，105例（22.5%）死于RCC，113例（24.2%）死于其他原因，中位随访时间为90个月。近代队列的OS、CSS和RFS明显长于早期队列：结论：近期（2000-2018 年）接受治疗的 RCC 患者的生存期明显长于早期（1981-1999 年）接受治疗的患者。生存率的提高可能与微创（腹腔镜/机器人）手术的普及有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Urology 医学-泌尿学与肾脏学

CiteScore

4.70

自引率

11.50%

发文量

340

审稿时长

3 months

期刊介绍： International Journal of Urology is the official English language journal of the Japanese Urological Association, publishing articles of scientific excellence in urology. Submissions of papers from all countries are considered for publication. All manuscripts are subject to peer review and are judged on the basis of their contribution of original data and ideas or interpretation.