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  • Almdalal, T.Department of Surgery and Urology, Eskilstuna Country Hospital, Eskilstuna, Sweden,Eskilstuna Country Hosp, Dept Surg & Urol, Eskilstuna, Sweden. (author)

Clinical T1a Renal Cell Carcinoma, Not Always a Harmless Disease-A National Register Study

  • Article/chapterEnglish2022

Publisher, publication year, extent ...

  • Elsevier BV,2022

Numbers

  • LIBRIS-ID:oai:gup.ub.gu.se/316559
  • https://gup.ub.gu.se/publication/316559URI
  • https://doi.org/10.1016/j.euros.2022.03.005DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-98918URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-193794URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:149501879URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-475474URI

Supplementary language notes

  • Language:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Funding agencies:Swedish Association of Local Authorities and Regions (SALAR)Clinical Research Center in the county of Sörmland, Sweden
  • Background: T1a renal cell carcinoma (RCC) is typically considered a curable dis-ease, irrespective of the choice of local treatment modality.& nbsp;Objective: To identify factors associated with the risk of local and distant recur-rence, and overall survival (OS) in patients with primary nonmetastatic clinical T1a RCC.& nbsp;Design, setting, and participants: A population-based nationwide register study of all 1935 patients with cT1a RCC, diagnosed during 2005-2012, identified through The National Swedish Kidney Cancer Register, was conducted.& nbsp;Outcome measurements and statistical analysis: Outcome variables were recur-rence (local or distant) and OS. Possible explanatory variables included tumor size, RCC type, T stage, surgical technique, age, and gender. Associations with disease recurrence and OS were evaluated by multivariable regression and Cox multivari-ate analyses, respectively.& nbsp;& nbsp;Results and limitations: Among 1935 patients, 938 were treated with radical nephrectomy, 738 with partial nephrectomy, and 169 with ablative treatments, while 90 patients had no surgery. Seventy-eight (4%) patients were upstaged to pT3. Local or metastatic recurrences occurred in 145 (7.5%) patients, significantly more often after ablation (17.8%). The risk of recurrence was associated with tumor size, upstaging, and ablation. Larger tumor size, disease recurrence, and older age adversely affected OS, whereas partial nephrectomy and chromophobe RCC (chRCC) were associated with improved survival. Limitations include register design and a lack of comorbidity or performance status data.& nbsp;Conclusions: Upstaging and recurrence occurred, respectively, in 4.0% and 7.5% of patients with nonmetastatic RCCs <= 4 cm. Tumor size upstaging and ablation were associated with the risk for recurrence, while tumor size and recurrence were associated with decreased OS. Patients with chRCC and partial nephrectomy had prolonged OS in a real-world setting.& nbsp;Patient summary: We studied factors that may influence the risk of disease recurrence and overall survival, in a large nationwide patient cohort having non metastatic renal cell carcinoma < 4 cm. Tumor size, tumor type, and treatment were associated with the risk of recurrence and overall death. Partial nephrectomy prolonged overall survival. (C)2022 The Author(s). Published by Elsevier B.V. on behalf of European Association of Urology.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Sundqvist, Pernilla,1973-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Urology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden,Örebro Univ, Fac Med & Hlth, Dept Urol, Örebro, Sweden.(Swepub:oru)pst (author)
  • Harmenberg, U.Department of Oncology, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden,Karolinska Univ Hosp, Dept Oncol, Stockholm, Sweden. (author)
  • Hellström, Mikael,1950Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology,Department of Radiology, Sahlgrenska Academy/Sahlgrenska University Hospital, Gothenburg University, Gothenburg, Sweden.(Swepub:gu)xhelmi (author)
  • Lindskog, magli409Uppsala universitet,Karolinska Institutet,Experimentell och klinisk onkologi(Swepub:uu)magli409 (author)
  • Lindblad, Per,1953-Örebro universitet,Institutionen för medicinska vetenskaper,School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.(Swepub:oru)pld (author)
  • Lundstam, Sven,1944Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institutionen för kliniska vetenskaper, Avdelningen för onkologi,Institute of Clinical Sciences, Department of Urology,Institute of Clinical Sciences, Department of Oncology,Department of Urology and Oncology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.(Swepub:gu)xlusvl (author)
  • Ljungberg, Börje,Professor,1949-Umeå universitet,Urologi och andrologi,Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden.(Swepub:umu)bolj0001 (author)
  • Department of Surgery and Urology, Eskilstuna Country Hospital, Eskilstuna, SwedenEskilstuna Country Hosp, Dept Surg & Urol, Eskilstuna, Sweden. (creator_code:org_t)

Related titles

  • In:European Urology Open Science: Elsevier BV39, s. 22-282666-16912666-1683

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