Kidney Cancer Coverage from Every Angle

Cancer-Specific Mortality in Nonmetastatic Renal Cell Carcinoma After Nephrectomy

By: Sarah Campen, PharmD
Posted: Thursday, February 13, 2020

For patients with nonmetastatic renal cell carcinoma who are treated with nephrectomy, tumor stage and substages are essential determinants of prognosis after lengthy event-free follow-up, according to findings published in JNCCN–Journal of the National Comprehensive Cancer Network. The risk of cancer-specific mortality in patients with pT1aN0 disease remained stable, even after 10-year event-free follow-up, whereas the prognosis for patients with stage pT4N0/pTanyN1 disease improved drastically in proportion to the duration of event-free follow-up.

“Cancer-specific mortality risk showed important variability across the range of examined stage categories,” stated Carlotta Palumbo, MD, of the University of Montreal Health Center, Canada, and colleagues. “Our observations have critical importance for physicians regarding patient follow-up and counseling.”

The investigators focused on patients in the Surveillance, Epidemiology, and End Results (SEER) database from 2001 to 2015 with nonmetastatic renal cell carcinoma treated with a partial or radical nephrectomy. According to T and N stages and substage groupings, the following patients were included in the study: 35,966 with pT1aN0 disease (46.2%); 18,858 with pT1bN0 disease (24.2%); 5,977 with pT2aN0 disease (7.7%); 2,511 with pT2bN0 disease (3.2%); 11,839 with pT3aN0 disease (15.2%); 1,037 with pT3b–cN0 disease (1.3%); 402 with pT4N0 disease (0.5%); and 1,302 with pTanyN1 disease (1.7%).

For patients with pT1aN0 disease, conditional cancer-specific mortality survival estimates were 98.2% at 1 year versus 98.0% at 10 years of event-free follow-up. For patients with more advanced disease—pT4N0 or pTanyN1—the conditional survival estimates were 55.8% at 1 year versus 77.9% at 8 years of event-free follow-up. “Patients with the most aggressive T- and N-stage subgroupings benefit the most from event-free follow-up,” concluded the authors.

Disclosure: The study authors reported no conflicts of interest.

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