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Renal cell carcinoma stage migration in a single European centre over 25 years: effects on 5- and 10-year metastasis-free survival

  • Urology – Original Paper
  • Published:
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Abstract

Purpose

To assess renal cell carcinoma (RCC) stage migration in a large European academic centre series over 25 years and its possible impact on patients’ metastasis-free survival.

Methods

The pathology reports of 2,333 consecutive patients with RCC who underwent nephrectomy from 1984 to 2006 at our institution were systematically re-evaluated. Patients were pooled into four groups according to the date of surgery: group 1: 1984–1989, group 2: 1990–1995, group 3: 1996–2001 and group 4: 2002–2006, respectively. Changes in pT-categories over time and the impact on 5- and 10-year metastasis-free survival were evaluated.

Results

Organ-confined (pT1 and pT2) tumours were found in 191/502 (38.0 %) and 372/535 (69.5 %) surgical specimens in groups 1 and 4, respectively (p < 0.001). This stage migration was mainly the result of an increase in pT1a tumours (overall: 32.6 %) from 12.5 % in group 1 to 45.8 % in group 4 and a decrease in pT3a tumours (overall: 24.1 %) from 46.6 % in group 1 to 11.0 % in group 4 (p < 0.001). The mean tumour size decreased from 6.7 cm in group 1 to 4.8 cm in group 4 (p < 0.001). In 2,152 patients with non-metastatic RCC, median follow-up was 76.2 (interquartile range: 36.2–133.9) months. Five- and 10-year metastasis-free survival probabilities were 78.7 and 71.9 % in group 1, 85.3 and 80.0 % in group 2, and 86.9 and 82.7 % in group 3, respectively. Five-year metastasis-free survival in group 4 was 90.3 % (p < 0.001).

Conclusion

A statistically significant stage migration towards organ-confined RCC was observed in the cohort studied. This stage migration was accompanied by a significant improvement in metastasis-free survival comparing the period 1984–1989 and following time periods.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Division of Oncology, Department of Internal Medicine, Medical University of Graz (MUG), Auenbruggerplatz 25, 8036, Graz, Austria

    Martin Pichler

  2. Department of Urology, Medical University of Graz (MUG), Graz, Austria

    Georg C. Hutterer, Thomas F. Chromecki, Johanna Jesche, Karin Kampel-Kettner, Karl Pummer & Richard Zigeuner

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  1. Martin Pichler
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  2. Georg C. Hutterer
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  3. Thomas F. Chromecki
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  4. Johanna Jesche
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  5. Karin Kampel-Kettner
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  6. Karl Pummer
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  7. Richard Zigeuner
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Corresponding author

Correspondence to Martin Pichler.

Additional information

Martin Pichler and Georg C. Hutterer contributed equally to this study.

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Pichler, M., Hutterer, G.C., Chromecki, T.F. et al. Renal cell carcinoma stage migration in a single European centre over 25 years: effects on 5- and 10-year metastasis-free survival. Int Urol Nephrol 44, 997–1004 (2012). https://doi.org/10.1007/s11255-012-0165-5

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  • DOI: https://doi.org/10.1007/s11255-012-0165-5

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