Predicting Factors for Death from Other Causes in Patients with Localized Renal Cell Carcinoma
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ÀåÁø¼® ( Chang Jin-Suk )
Seoul National University College of Medicine Department of Urology
¹Ú¿ëÇö ( Park Yong-Hyun )
Seoul National University College of Medicine Department of Urology
±¸ÀÚÇö ( Ku Ja-Hyun )
Seoul National University College of Medicine Department of Urology
°ûö ( Kwak Cheol )
Seoul National University College of Medicine Department of Urology
±èÇöȸ ( Kim Hyeon-Hoe )
Seoul National University College of Medicine Department of Urology
KMID : 0358320120530010018
Abstract
Purpose: To identify the predictors of death from other causes in patients with localized renal cell carcinoma (RCC).
Materials and Methods: We identified 1,101 patients with pathologically confirmed T1 or T2 RCC with a follow-up duration of over 6 months. Survival according to the cause of death was evaluated by using the Kaplan-Meier analysis with log-rank test. Prognostic factors for death from other causes were assessed by multivariate analysis using the Cox proportional hazard regression model. Once the prognostic factors were identified, a risk-group variable was created by counting the number of unfavorable features present for each patient.
Results: The median follow-up was 62 months, and RCC-related death occurred in 50 patients (4.5%), whereas death from other causes occurred in 47 (4.3%). Patients who died from other causes had a higher American Society of Anesthesiologist (ASA) score (26.1% vs. 10.2%; p=0.044), older age (63.4 years vs. 55.0 years; p<0.001), smaller mass size (5.1 cm vs. 7.9 cm; p<0.001), and lower nuclear grade (p=0.003). In the multivariate Cox regression analysis, older age, higher ASA score, and lower body mass index were independent factors predicting death from other causes in patients with localized RCC. On the basis of the number of risk factors for death from other causes, the 5-year other-cause-specific survival was 98.3% (0 risk factors), 84.7% (1 risk factor), and 67.6% (2 or 3 risk factors), respectively (p<0.001).
Conclusions: Older age, higher ASA score, and lower body mass index were independent predictors of death from other causes in patients with localized RCC.
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Mortality; Renal cell carcinoma; Watchful waiting
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