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

Research output: Contribution to journalArticle

2 Citations (Scopus)

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
StatePublished - Feb 1 2014
Externally publishedYes

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Kidney
Neoplasm Metastasis
Neoplasms
Survival
Kidney Neoplasms
Mortality
Therapeutics
Proportional Hazards Models
Immunotherapy
Logistic Models
Radiation
Drug Therapy

Keywords

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

ASJC Scopus subject areas

  • Urology

Cite this

Age-an independent prognostic factor of clinical outcome in renal malignancies : Results of a large study over two decades. / Hupe, Marie C.; Merseburger, Axel S.; Lokeshwar, Vinata B; Eggers, Hendrik; Rott, Hendrik; Wegener, Gerd; Abbas, Mahmoud; Kuczyk, Markus A.; Herrmann, Thomas R.

In: World Journal of Urology, Vol. 32, No. 1, 01.02.2014, p. 115-121.

Research output: Contribution to journalArticle

Hupe, MC, Merseburger, AS, Lokeshwar, VB, Eggers, H, Rott, H, Wegener, G, Abbas, M, Kuczyk, MA & Herrmann, TR 2014, 'Age-an independent prognostic factor of clinical outcome in renal malignancies: Results of a large study over two decades', World Journal of Urology, vol. 32, no. 1, pp. 115-121. https://doi.org/10.1007/s00345-013-1164-6
Hupe, Marie C. ; Merseburger, Axel S. ; Lokeshwar, Vinata B ; Eggers, Hendrik ; Rott, Hendrik ; Wegener, Gerd ; Abbas, Mahmoud ; Kuczyk, Markus A. ; Herrmann, Thomas R. / Age-an independent prognostic factor of clinical outcome in renal malignancies : Results of a large study over two decades. In: World Journal of Urology. 2014 ; Vol. 32, No. 1. pp. 115-121.
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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.",
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AU - Lokeshwar, Vinata B

AU - Eggers, Hendrik

AU - Rott, Hendrik

AU - Wegener, Gerd

AU - Abbas, Mahmoud

AU - Kuczyk, Markus A.

AU - Herrmann, Thomas R.

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N2 - 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.

AB - 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.

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