Frequency, incidence and survival outcomes of clear cell renal cell carcinoma in the United States from 1973 to 2014: A SEER-based analysis

Abstract

The epidemiological and prognostic data focusing on clear cell renal cell carcinoma (ccRCC) are rarely presented. This study was aimed to define the frequency, incidence, and survival outcomes of ccRCC in the United States.The Surveillance, Epidemiology, and End Results (SEER) database was searched for patients with ccRCC from 1973 to 2014. Two patient cohorts were utilized: patient cohorts of SEER 18 registries and 9 registries. Overall survival was determined with Kaplan-Meier method and compared across groups with log-rank test.The incidence rate of ccRCC increased with advancing age, peaked in individuals aged 60 to 79 years, and declined in individuals aged ≥80 years. The incidence rate of ccRCC was significantly higher in males than females (1.94: 1, P < .0001), in Whites than Blacks or others (1:0.79:0.91, P < .0001). The incidence rate of ccRCC with right side as primary origin was slightly but significantly higher than that with left side as primary origin (1:0.96, P = .0006). The incidence rate of ccRCC in Grade II was higher than other grades. Generally, the incidence rates of ccRCC in most circumstances started to surge in the middle 1990s. Survival outcomes of ccRCC worsened with advancing age at diagnosis, tumor grade, and stage. A better prognosis was observed in females than males, in Whites than Blacks, and in individuals diagnosed in 2006 to 2014 than 1973 to 2005.To the best of our knowledge, the present study firstly presented long-term and updated epidemiological and prognostic data concerning ccRCC in the United States. Significant differences in incidence rates and survival outcomes stratified by different variables were identified.

Figure 1

Curve plots showed the long-term trends in incidence rate of patients with clear cell renal cell carcinoma in the database of Surveillance, Epidemiology, and End Results 9 registries from 1973 to 2014 by different variables.

Figure 2

With Joinpoint Regression Program, the APC in incidence rates of clear cell renal cell carcinoma stratified by age (A) and sex (B) was analyzed in the database of Surveillance, Epidemiology, and End Results 9 registries from 1973 to 2014. ∗Indicates that the APC is significantly different from zero at the alpha = 0.05 level. APC = annual percent change.

Figure 3

With Joinpoint Regression Program, the APC in incidence rates of clear cell renal cell carcinoma stratified by race (A) and laterality (B) was analyzed in the database of Surveillance, Epidemiology, and End Results 9 registries from 1973 to 2014. ∗ Indicates that the APC is significantly different from zero at the alpha = 0.05 level. APC = annual percent change.

Figure 4

With Joinpoint Regression Program, the APC in incidence rates of clear cell renal cell carcinoma stratified by grade was analyzed in the database of Surveillance, Epidemiology, and End Results 9 registries from 1973 to 2014. ∗Indicates that the APC is significantly different from zero at the alpha = 0.05 level. APC = annual percent change.

Figure 5

Kaplan–Meier survival curves showed the survival outcomes of patients with clear cell renal cell carcinoma (ccRCC) stratified by different variables. (A) Overall survival (OS) decreased significantly with advancing age at diagnosis (log-rank test, P < .001). (B) The survival in females was significantly superior to that in males (log-rank test, P < .001). (C) The survival outcomes differed significantly by race (log-rank test, P < .001). (D) The survival of ccRCC patients with right side as primary origin was slightly but significantly better than that with left side as primary origin (log-rank test, P < .001). (E) OS declined significantly with increasing grade (log rank test, P < .001). (F) OS declined significantly with increasing stage (log rank test, P < .001). (G) The survival of ccRCC patients diagnosed in 2006 to 2014 was significantly superior to that in 1973 to 2005 (log-rank test, P < .001).