Oncologic Outcomes in Young Adults With Kidney Cancer Treated During the Targeted Therapy Era
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Citações na Scopus
3
Tipo de produção
article
Data de publicação
2020
Título da Revista
ISSN da Revista
Título do Volume
Editora
CIG MEDIA GROUP, LP
Citação
CLINICAL GENITOURINARY CANCER, v.18, n.2, p.E134-E144, 2020
Resumo
We studied the oncologic outcomes of young adults with kidney cancer who were treated after the introduction of targeted therapy. Additionally, we analyzed the impact of young age (< 40 years) on survival and recurrencefree survival. We found that young patients usually present with more advanced stages of the disease and have worse overall survival. Background: The objective of this study was to determine the outcomes of young adults with kidney cancer treated during the targeted therapy era and evaluate the impact of young age on survival. Materials and Methods: We reviewed the records from 445 patients younger than 55 years with kidney cancer at a single institution from 2006 to 2017. Overall survival (OS) and recurrence-free survival were estimated with the Kaplan-Meier method and log-rank test. Cox proportional hazards regression was used to determine the impact of clinical and pathologic variables on all-cause mortality. Results: Overall, 104 (23%) patients 40 years or younger were compared with 341 (77%) patients who were 41 to 55 years old. Younger patients presented with more advanced stages of the disease, including metastasis at diagnosis, positive lymph nodes, venous tumor thrombus and had more non-clear cell tumors (54% vs. 30%; P < .001). Young adults had significantly worse OS at 2 and 5 years (67% vs. 82% and 53% vs. 69%, respectively). Younger patients with metastatic disease received targeted agents less often compared with the older group (64% vs. 75%). There was no difference in recurrence-free survival across patients with localized disease. Independent prognostic factors associated with increased mortality were metastasis at diagnosis, pT2 or greater, and age younger than 40 years (hazard ratio, 1.65; 95% confidence interval, 1.0-2.6; P = .03). Conclusion: Patients younger than 40 years with kidney tumors treated during the targeted therapy era have worse OS compared with older adults. Young age is an independent predictor of mortality.
Palavras-chave
Kidney neoplasm, Prognostic factors, Renal cell carcinoma, Systemic therapy, Young adults
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