Preoperative Chronic Kidney Disease Status is an Independent Prognostic Factor in Patients with Renal Cell Carcinoma

Young Won Kim, Won Tae Kim, Seok Joong Yun, Sang Cheol Lee, Wun Jae Kim, Yun Sok Ha, Yong Hyun Park, Seok Ho Kang, Sung Hoo Hong, Tae Gyun Kwon, Seok Soo Byun, Cheol Kwak, Yong June Kim

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Purpose: Preoperative chronic kidney disease (CKD) status may affect disease outcomes in patients with renal cell carcinoma (RCC). This study evaluated the influence of preoperative CKD status on clinicopathological features and prognosis in patients with RCC. Methods: Between 1999 and 2011, a total of 1855 patients underwent radical nephrectomy at various centers throughout Korea. Of these patients, 1655 had an estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73 m2 (non-CKD group) and 200 patients had an eGFR ≥30 but <60 ml/min/1.73 m2 (CKD group). To reduce the effects of selection bias and potential confounding factors, 600 patients in the non-CKD group were selected by propensity-score matching. Results: The median age of all patients was 57.3 years (range 20–94 years) and the median follow-up was 35.0 months (range 1–154 months). Comparisons of the propensity-score-matched cohorts showed that T and N stages were more advanced and tumor size was larger in the CKD group than in the non-CKD group (p < 0.05 each). Kaplan–Meier analyses showed that recurrence-free survival, cancer-specific survival (CSS), and overall survival (OS) were significantly lower in the CKD group (p < 0.01 each). Multivariate regression analysis showed that preoperative CKD status was an independent predictor of CSS and OS in patients with RCC (p < 0.05 each). Conclusions: Preoperative CKD may be associated with more aggressive features and poorer prognosis in patients with RCC. RCC patients with preoperative CKD should be carefully and frequently followed-up after nephrectomy.

Original languageEnglish
Pages (from-to)4098-4103
Number of pages6
JournalAnnals of Surgical Oncology
Volume22
Issue number12
DOIs
StatePublished - 1 Nov 2015

Fingerprint

Chronic Renal Insufficiency
Renal Cell Carcinoma
Kidney Diseases
Survival
Propensity Score
Nephrectomy
Glomerular Filtration Rate
Neoplasms
Selection Bias
Korea
Multivariate Analysis
Regression Analysis
Recurrence

Cite this

Kim, Young Won ; Kim, Won Tae ; Yun, Seok Joong ; Lee, Sang Cheol ; Kim, Wun Jae ; Ha, Yun Sok ; Park, Yong Hyun ; Kang, Seok Ho ; Hong, Sung Hoo ; Kwon, Tae Gyun ; Byun, Seok Soo ; Kwak, Cheol ; Kim, Yong June. / Preoperative Chronic Kidney Disease Status is an Independent Prognostic Factor in Patients with Renal Cell Carcinoma. In: Annals of Surgical Oncology. 2015 ; Vol. 22, No. 12. pp. 4098-4103.
@article{3f70b3011eba4791b3ff599bf005ff47,
title = "Preoperative Chronic Kidney Disease Status is an Independent Prognostic Factor in Patients with Renal Cell Carcinoma",
abstract = "Purpose: Preoperative chronic kidney disease (CKD) status may affect disease outcomes in patients with renal cell carcinoma (RCC). This study evaluated the influence of preoperative CKD status on clinicopathological features and prognosis in patients with RCC. Methods: Between 1999 and 2011, a total of 1855 patients underwent radical nephrectomy at various centers throughout Korea. Of these patients, 1655 had an estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73 m2 (non-CKD group) and 200 patients had an eGFR ≥30 but <60 ml/min/1.73 m2 (CKD group). To reduce the effects of selection bias and potential confounding factors, 600 patients in the non-CKD group were selected by propensity-score matching. Results: The median age of all patients was 57.3 years (range 20–94 years) and the median follow-up was 35.0 months (range 1–154 months). Comparisons of the propensity-score-matched cohorts showed that T and N stages were more advanced and tumor size was larger in the CKD group than in the non-CKD group (p < 0.05 each). Kaplan–Meier analyses showed that recurrence-free survival, cancer-specific survival (CSS), and overall survival (OS) were significantly lower in the CKD group (p < 0.01 each). Multivariate regression analysis showed that preoperative CKD status was an independent predictor of CSS and OS in patients with RCC (p < 0.05 each). Conclusions: Preoperative CKD may be associated with more aggressive features and poorer prognosis in patients with RCC. RCC patients with preoperative CKD should be carefully and frequently followed-up after nephrectomy.",
author = "Kim, {Young Won} and Kim, {Won Tae} and Yun, {Seok Joong} and Lee, {Sang Cheol} and Kim, {Wun Jae} and Ha, {Yun Sok} and Park, {Yong Hyun} and Kang, {Seok Ho} and Hong, {Sung Hoo} and Kwon, {Tae Gyun} and Byun, {Seok Soo} and Cheol Kwak and Kim, {Yong June}",
year = "2015",
month = "11",
day = "1",
doi = "10.1245/s10434-015-4444-0",
language = "English",
volume = "22",
pages = "4098--4103",
journal = "Annals of surgical oncology",
issn = "1068-9265",
publisher = "Springer New York",
number = "12",

}

Kim, YW, Kim, WT, Yun, SJ, Lee, SC, Kim, WJ, Ha, YS, Park, YH, Kang, SH, Hong, SH, Kwon, TG, Byun, SS, Kwak, C & Kim, YJ 2015, 'Preoperative Chronic Kidney Disease Status is an Independent Prognostic Factor in Patients with Renal Cell Carcinoma', Annals of Surgical Oncology, vol. 22, no. 12, pp. 4098-4103. https://doi.org/10.1245/s10434-015-4444-0

Preoperative Chronic Kidney Disease Status is an Independent Prognostic Factor in Patients with Renal Cell Carcinoma. / Kim, Young Won; Kim, Won Tae; Yun, Seok Joong; Lee, Sang Cheol; Kim, Wun Jae; Ha, Yun Sok; Park, Yong Hyun; Kang, Seok Ho; Hong, Sung Hoo; Kwon, Tae Gyun; Byun, Seok Soo; Kwak, Cheol; Kim, Yong June.

In: Annals of Surgical Oncology, Vol. 22, No. 12, 01.11.2015, p. 4098-4103.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Preoperative Chronic Kidney Disease Status is an Independent Prognostic Factor in Patients with Renal Cell Carcinoma

AU - Kim, Young Won

AU - Kim, Won Tae

AU - Yun, Seok Joong

AU - Lee, Sang Cheol

AU - Kim, Wun Jae

AU - Ha, Yun Sok

AU - Park, Yong Hyun

AU - Kang, Seok Ho

AU - Hong, Sung Hoo

AU - Kwon, Tae Gyun

AU - Byun, Seok Soo

AU - Kwak, Cheol

AU - Kim, Yong June

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Purpose: Preoperative chronic kidney disease (CKD) status may affect disease outcomes in patients with renal cell carcinoma (RCC). This study evaluated the influence of preoperative CKD status on clinicopathological features and prognosis in patients with RCC. Methods: Between 1999 and 2011, a total of 1855 patients underwent radical nephrectomy at various centers throughout Korea. Of these patients, 1655 had an estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73 m2 (non-CKD group) and 200 patients had an eGFR ≥30 but <60 ml/min/1.73 m2 (CKD group). To reduce the effects of selection bias and potential confounding factors, 600 patients in the non-CKD group were selected by propensity-score matching. Results: The median age of all patients was 57.3 years (range 20–94 years) and the median follow-up was 35.0 months (range 1–154 months). Comparisons of the propensity-score-matched cohorts showed that T and N stages were more advanced and tumor size was larger in the CKD group than in the non-CKD group (p < 0.05 each). Kaplan–Meier analyses showed that recurrence-free survival, cancer-specific survival (CSS), and overall survival (OS) were significantly lower in the CKD group (p < 0.01 each). Multivariate regression analysis showed that preoperative CKD status was an independent predictor of CSS and OS in patients with RCC (p < 0.05 each). Conclusions: Preoperative CKD may be associated with more aggressive features and poorer prognosis in patients with RCC. RCC patients with preoperative CKD should be carefully and frequently followed-up after nephrectomy.

AB - Purpose: Preoperative chronic kidney disease (CKD) status may affect disease outcomes in patients with renal cell carcinoma (RCC). This study evaluated the influence of preoperative CKD status on clinicopathological features and prognosis in patients with RCC. Methods: Between 1999 and 2011, a total of 1855 patients underwent radical nephrectomy at various centers throughout Korea. Of these patients, 1655 had an estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73 m2 (non-CKD group) and 200 patients had an eGFR ≥30 but <60 ml/min/1.73 m2 (CKD group). To reduce the effects of selection bias and potential confounding factors, 600 patients in the non-CKD group were selected by propensity-score matching. Results: The median age of all patients was 57.3 years (range 20–94 years) and the median follow-up was 35.0 months (range 1–154 months). Comparisons of the propensity-score-matched cohorts showed that T and N stages were more advanced and tumor size was larger in the CKD group than in the non-CKD group (p < 0.05 each). Kaplan–Meier analyses showed that recurrence-free survival, cancer-specific survival (CSS), and overall survival (OS) were significantly lower in the CKD group (p < 0.01 each). Multivariate regression analysis showed that preoperative CKD status was an independent predictor of CSS and OS in patients with RCC (p < 0.05 each). Conclusions: Preoperative CKD may be associated with more aggressive features and poorer prognosis in patients with RCC. RCC patients with preoperative CKD should be carefully and frequently followed-up after nephrectomy.

UR - http://www.scopus.com/inward/record.url?scp=84943356311&partnerID=8YFLogxK

U2 - 10.1245/s10434-015-4444-0

DO - 10.1245/s10434-015-4444-0

M3 - Article

C2 - 25851339

AN - SCOPUS:84943356311

VL - 22

SP - 4098

EP - 4103

JO - Annals of surgical oncology

JF - Annals of surgical oncology

SN - 1068-9265

IS - 12

ER -