Treatment trends, determinants, and survival of partial and radical nephrectomy for stage I renal cell carcinoma: results from the National Cancer Data Base, 2004-2013

Abstract

Objective: To provide updated treatment trends, determinants, and survival of partial nephrectomy (PN) and radical nephrectomy (RN) across the USA.

Data sources: Secondary data from the National Cancer Data Base (NCDB) participant user file from 2004 to 2013. The NCDB captures approximately 70% of all newly diagnosed cancer cases each year.

Study design: Multivariable logistic regression was used to estimate odds ratios for RN overall. Kaplan-Meier, multivariable Cox regression, and log-rank test were used to characterize patient survival.

Data collection: Patients diagnosed with clinical stage I RCC who received either RN or PN as the primary surgical treatment were included.

Principle findings: The study consisted of 121,386 cases (PN = 57,016; RN = 64,370). The overall use of PN for stage I RCC increased by 24.2% over 9 years. An overall 5- and 10-year survival advantage was estimated following PN compared to RN; estimated overall risk of death was higher with RN.

Conclusions: The use of PN for stage I RCC has continued to increase and is associated with an overall survival advantage. Multivariable analysis showed that disparities exist among sociodemographic groups that are also associated with treatment type and survival.

Keywords: Carcinoma; Epidemiology; Outcomes; Partial nephrectomy; Radical nephrectomy; Renal cell.