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. 2013 Apr 16;108(7):1541-9.
doi: 10.1038/bjc.2013.119. Epub 2013 Mar 26.

Treatment and overall survival in renal cell carcinoma: a Swedish population-based study (2000-2008)

T Wahlgren  1 , U Harmenberg, P Sandström, S Lundstam, J Kowalski, M Jakobsson, R Sandin, B Ljungberg
Affiliations

Treatment and overall survival in renal cell carcinoma: a Swedish population-based study (2000-2008)

T Wahlgren et al. Br J Cancer. .

Abstract

Background: This retrospective register study assessed overall survival (OS) and influential factors on OS in Swedish renal cell carcinoma (RCC) patients.

Methods: Using three merged national health registers, Cox proportional-hazards analysis was conducted and, in three models, it was used to assess the impact of cytokine (interferon-α and tyrosine kinase inhibitor (TKI; sunitinib or sorafenib) treatment on OS in metastatic (m)RCC.

Results: From 2000 to 2008, 8009 patients were diagnosed with RCC and 2753 with mRCC (2002-2008). Median OS in RCC patients diagnosed from 2006 to 2008 compared with 2000-2005 was not reached vs 47.9 months (P<0.001), and in mRCC patients diagnosed from 2006 to 2008 compared with 2002-2005, was 12.4 vs 9.6 months, respectively (P=0.004). Factors associated with significantly improved OS in RCC were female gender, lower age, and previous nephrectomy, and, in mRCC female gender, previous nephrectomy, and any TKI prescription (Model 1: median-adjusted OS, 19.4 months (TKI patients) vs 9.7 months (non-TKI patients); hazard ratio, 0.621; P<0.001).

Conclusion: OS was improved in Swedish patients diagnosed with RCC and mRCC in the period 2006-2008 compared with 2000-2005 (RCC) and 2002-2005 (mRCC). Although multifactorial in origin, results suggest that increased nephrectomy rates and the use of TKIs contributed to the improvement seen in mRCC patients.

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Figures

Figure 1
Figure 1
Patients who received first- and second-line mRCC treatment included in the Cox proportional-hazards models.
Figure 2
Figure 2
Kaplan–Meier estimates of OS in Swedish patients diagnosed with RCC (A) by year of diagnosis and (B) between the periods 2000–2005 and 2006–2008. NA, not applicable. Cl, confidence interval; NA, not available; NR, not reached.
Figure 3
Figure 3
Kaplan–Meier estimates of OS in Swedish patients diagnosed with mRCC (A) by year of diagnosis and (B) between the periods 2002–2005 and 2006–2008. Cl, confidence interval; NA, not available; NR, not reached.
Figure 4
Figure 4
Cumulative OS adjusted by multivariate Cox proportional-hazards regression analysis (Model 1) in TKI- and non-TKI-treated Swedish patients diagnosed with mRCC. HR, hazard ratio; TKI, tyrosine kinase inhibitor.
Figure 5
Figure 5
Cumulative OS adjusted by multivariate Cox proportional-hazards regression analysis (Model 2) by first-line treatment in Swedish patients diagnosed with mRCC. HR, hazard ratio.
See this image and copyright information in PMC

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