Age-an independent prognostic factor of clinical outcome in renal malignancies: Results of a large study over two decades

Marie C. Hupe, Axel S. Merseburger, Vinata B. Lokeshwar, Hendrik Eggers, Hendrik Rott, Gerd Wegener, Mahmoud Abbas, Markus A. Kuczyk, Thomas R. Herrmann

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2 Scopus citations

Abstract

Purpose: Age has been linked to outcome in renal cancer patients, but mainly in North American cohorts. In this study, we hypothesized that age is correlated with metastasis and cancer-specific survival in a German cohort regardless of types of treatments. Methods: A total of 1,538 patients treated for renal malignancies between 1991 and 2010 were evaluated. Mean age and median age are 61.9 ± 11.6 and 62.6 years. Clinicopathologic [tumor type, size, grade, stage and treatment (surgery, chemotherapy, radiation, immunotherapy)] and outcome parameters (metastasis and survival) were examined for an association with age using logistic regression and Cox proportional hazard model, and Kaplan-Meier plots. Results: Age was associated with stage, metastasis, treatment, cancer-specific and overall mortality (p < 0.01). The metastasis-free and cancer-free survival rates for patients >63 years were lower than those for patients ≤63 years (p < 0.0001). In a multivariate analysis, age was an independent prognostic factor of metastasis, cancer-specific and overall mortality (p < 0.0001) even when data were stratified in different decades and treatment was included as one of the parameters. Patients >63 years of age had 29-35 % higher risk of metastasis and cancer-specific mortality than younger patients. Median metastasis-free and cancer-specific survival for patients >63 years of age (months: 84.4; 70.3) was ~50 % shorter than in patients ≤63 years (months: 151; 144.6). Conclusions: This large study shows that, despite advances in surgical and non-surgical treatment modalities over the two decades, age is an independent prognostic indicator of metastasis and cancer-specific mortality in renal cancer patients. Patients >63 years have ~30 % increased risk for metastasis and ~50 % shorter cancer-specific survival.

Original languageEnglish (US)
Pages (from-to)115-121
Number of pages7
JournalWorld Journal of Urology
Volume32
Issue number1
DOIs
Publication statusPublished - Feb 1 2014
Externally publishedYes

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Keywords

  • Age
  • Cancer-specific survival
  • Metastasis
  • Prognostic indicators
  • Renal malignancies
  • Treatment

ASJC Scopus subject areas

  • Urology

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