Nodal involvement at nephrectomy is associated with worse survival: A stage-for-stage and grade-for-grade analysis

Maxine Sun, Marco Bianchi, Jens Hansen, Firas Abdollah, Quoc Dien Trinh, Giovanni Lughezzani, Shahrokh F. Shariat, Francesco Montorsi, Paul Perrotte, Pierre I. Karakiewicz

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To examine cancer-specific mortality in patients with nodal metastases relative to patients without nodal involvement at nephrectomy for non-metastatic renal cell carcinoma in a population-based cohort. Methods: A total of 11374 non-metastatic renal cell carcinoma patients who underwent a lymph node dissection at nephrectomy were identified using the Surveillance, Epidemiology and End Results database (1988-2008). The 5-year cancer-specific mortality-free survival rates were examined according to the presence or absence of nodal involvement within the entire cohort, and stratified according to pathological tumor stage (pT1vspT2vspT3vspT4) and Fuhrman grade (IvsIIvsIIIvsIV). Cox regression analyses for prediction of cancer-specific mortality were modeled to assess the effect of nodal metastases versus no nodal involvement in the entire population. Finally, separate Cox regression models were fitted within each pathological stage and grade. Results: Overall, 1260 (11%) patients had nodal metastases at nephrectomy. The overall 5-year cancer-specific mortality-free survival rates were 38.4 versus 83.8% in patients with nodal metastases and without nodal metastases, respectively. In multivariable analyses, amongst pT1, pT2, pT3 and pT4, patients with nodal metastases were 6.0-, 3.6-, 3.2- and 2.0-fold, respectively, more likely to die after nephrectomy (all P

Original languageEnglish
Pages (from-to)372-380
Number of pages9
JournalInternational Journal of Urology
Volume20
Issue number4
DOIs
Publication statusPublished - Apr 2013

Keywords

  • Lymph node metastases
  • Nephrectomy
  • Renal cell carcinoma
  • Survival

ASJC Scopus subject areas

  • Urology

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