Lifestyle and Clinical Factors in a Nationwide Stage III and IV Renal Cell Carcinoma Study
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Lifestyle and Clinical Factors in a Nationwide Stage III and IV Renal Cell Carcinoma Study. / Azawi, Nessn; Ebbestad, Freja Ejlebaek; Nadler, Naomi; Mosholt, Karina Sif Soendergaard; Axelsen, Sofie Staal; Geertsen, Louise; Christensen, Jane; Jensen, Niels Viggo; Fristrup, Niels; Lund, Lars; Donskov, Frede; Dalton, Susanne Oksbjerg.
In: Cancers, Vol. 15, No. 18, 4488, 2023.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Lifestyle and Clinical Factors in a Nationwide Stage III and IV Renal Cell Carcinoma Study
AU - Azawi, Nessn
AU - Ebbestad, Freja Ejlebaek
AU - Nadler, Naomi
AU - Mosholt, Karina Sif Soendergaard
AU - Axelsen, Sofie Staal
AU - Geertsen, Louise
AU - Christensen, Jane
AU - Jensen, Niels Viggo
AU - Fristrup, Niels
AU - Lund, Lars
AU - Donskov, Frede
AU - Dalton, Susanne Oksbjerg
N1 - Publisher Copyright: © 2023 by the authors.
PY - 2023
Y1 - 2023
N2 - Background: The aim was to investigate whether patient-related or clinical risk factors present at the diagnosis of advanced stage renal cell carcinoma (RCC) had an impact on the overall mortality, cancer-specific mortality, and recurrence risk in a national cohort. Methods: Patients registered with stage III and IV RCC in the Danish Renal Cancer Database (DaRenCa) in 2014–2016 were included in the study and followed up until recurrence or death. We conducted a Cox Proportional Hazard Model to examine the association between several variables and the development of RCC. These variables included BMI, hypertension, smoking status, symptoms at diagnosis, performance status, multidisciplinary team (MDT) discussion, surgical margin, and primary metastasis. Separate analyses were performed for cc-RCC and non-ccRCC patients. Results: In our cohort of 929 patients, 424 individuals died from RCC during the follow-up period, with a median follow-up time of 4.1 (95% CI: 0.8–5.0) years for ccRCC and 2.0 (95% CI: 0.1–5.0) years for non-ccRCC. A multivariate analysis demonstrated that a positive surgical margin (HR 1.53 and 1.43), synchronous metastasis (HR 2.06 and 3.23), and poor performance status (HR 4.73 and 5.27) were significantly associated with a decreased 5-year overall and cancer-specific survival, respectively. Furthermore, a positive surgical margin was associated with a higher risk of recurrence in ccRCC. MDT discussion was found to reduce mortality risk in non-ccRCC. Conclusion: Clinical- and disease-related variables have a greater impact on RCC mortality and recurrence than the selected lifestyle-related factors. The inclusion of MDT discussion in the diagnosis and management of advanced RCC should be further evaluated for its potential to improve patient outcomes.
AB - Background: The aim was to investigate whether patient-related or clinical risk factors present at the diagnosis of advanced stage renal cell carcinoma (RCC) had an impact on the overall mortality, cancer-specific mortality, and recurrence risk in a national cohort. Methods: Patients registered with stage III and IV RCC in the Danish Renal Cancer Database (DaRenCa) in 2014–2016 were included in the study and followed up until recurrence or death. We conducted a Cox Proportional Hazard Model to examine the association between several variables and the development of RCC. These variables included BMI, hypertension, smoking status, symptoms at diagnosis, performance status, multidisciplinary team (MDT) discussion, surgical margin, and primary metastasis. Separate analyses were performed for cc-RCC and non-ccRCC patients. Results: In our cohort of 929 patients, 424 individuals died from RCC during the follow-up period, with a median follow-up time of 4.1 (95% CI: 0.8–5.0) years for ccRCC and 2.0 (95% CI: 0.1–5.0) years for non-ccRCC. A multivariate analysis demonstrated that a positive surgical margin (HR 1.53 and 1.43), synchronous metastasis (HR 2.06 and 3.23), and poor performance status (HR 4.73 and 5.27) were significantly associated with a decreased 5-year overall and cancer-specific survival, respectively. Furthermore, a positive surgical margin was associated with a higher risk of recurrence in ccRCC. MDT discussion was found to reduce mortality risk in non-ccRCC. Conclusion: Clinical- and disease-related variables have a greater impact on RCC mortality and recurrence than the selected lifestyle-related factors. The inclusion of MDT discussion in the diagnosis and management of advanced RCC should be further evaluated for its potential to improve patient outcomes.
KW - advanced stage renal cell carcinoma
KW - lifestyle-related factors
KW - multidisciplinary team discussion
KW - patient outcomes
KW - patient-related risk factors
U2 - 10.3390/cancers15184488
DO - 10.3390/cancers15184488
M3 - Journal article
C2 - 37760459
AN - SCOPUS:85172796235
VL - 15
JO - Cancers
JF - Cancers
SN - 2072-6694
IS - 18
M1 - 4488
ER -
ID: 388018234