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Pyrgidis N, Schulz GB, Stief C, Blajan I, Ivanova T, Graser A, Staehler M. Surgical Trends and Complications in Partial and Radical Nephrectomy: Results from the GRAND Study. Cancers (Basel) 2023; 16:97. [PMID: 38201523 PMCID: PMC10778168 DOI: 10.3390/cancers16010097] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND We aimed to evaluate the current trends in renal cancer surgery, as well as to compare the perioperative outcomes of partial versus radical nephrectomy. METHODS We used the GeRmAn Nationwide inpatient Data (GRAND), provided by the Research Data Center of the Federal Bureau of Statistics (2005-2021). We report the largest study in the field, with 317,843 patients and multiple patient-level analyses. RESULTS Overall, 123,924 (39%) patients underwent partial and 193,919 (61%) underwent radical nephrectomy in Germany from 2005 to 2021. Of them, 57,308 (18%) were operated on in low-, 142,702 (45%) in intermediate-, and 117,833 (37%) in high-volume centers. A total of 249,333 (78%) patients underwent open, 44,994 (14%) laparoscopic, and 23,516 (8%) robotic nephrectomy. The number of patients undergoing renal surgery remained relatively stable from 2005 to 2021. Over the study period, the utilization of partial nephrectomy increased threefold, while radical nephrectomy decreased by about 40%. After adjusting for major risk factors in the multivariate regression analysis, radical nephrectomy was associated with 3.2-fold higher odds (95% CI: 3.2 to 3.9, p < 0.001) of 30-day mortality, longer hospitalization by 1.9 days (95% CI: 1.9 to 2, p < 0.001), and higher inpatient costs by EUR 1778 (95% CI: 1694 to 1862, p < 0.001) compared to partial nephrectomy. Furthermore, radical nephrectomy had a higher risk of in-hospital transfusion (p < 0.001), sepsis (p < 0.001), acute respiratory failure (p < 0.001), acute kidney disease (p < 0.001), acute thromboembolism (p < 0.001), surgical wound infection (p < 0.001), ileus (p < 0.001), intensive care unit admission (p < 0.001), and pancreatitis (p < 0.001). CONCLUSIONS More patients are offered partial nephrectomy in Germany. Patients undergoing radical nephrectomy present with a higher rate of concomitant risk factors and have increased perioperative morbidity and mortality, prolonged hospitalization, and increased in-hospital costs.
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Affiliation(s)
| | | | | | | | | | | | - Michael Staehler
- Department of Urology, LMU University Hospital, LMU Munich, 81377 Munich, Germany; (N.P.); (G.B.S.); (C.S.); (I.B.); (T.I.); (A.G.)
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Wallace BK, Miles CH, Anderson CB. Effects of race and socioeconomic status on treatment for localized renal masses in New York City. Urol Oncol 2021; 40:65.e19-65.e26. [PMID: 34876349 DOI: 10.1016/j.urolonc.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/21/2021] [Accepted: 11/04/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Partial nephrectomy (PN) is the preferred treatment for localized renal masses (LRM), however its use is not uniform across patient socioeconomic (SES) factors. Our hypothesis is that the effect of increased SES on surgical management of LRMs in New York City (NYC) will not be the same for Black and White patients. PATIENTS AND METHODS Patients were identified from the New York State Cancer Registry (NYSPACED) treated for LRMs with PN or radical nephrectomy from 2004 to 2016. We identified patients' home neighborhoods through Public Use Microdata Areas (PUMA) in NYSCAPED and used a US Census SES index. Logistic regression was used to determine the association of race and SES on receipt of PN, controlling for age, ethnicity, gender, and diagnosis year. RESULTS On unadjusted analyses, patients from higher PUMA SES quartiles were more likely to receive PN (OR = 1.07, P < 0.05), while Black patients were less likely to receive PN as compared to White patients (OR = 0.66, P < 0.001). Multivariable analysis showed a significant interaction between race and SES quartile (interaction P = 0.005) such that the effect of PUMA SES on receipt of PN was modified by race. PN receipt for Black vs. White patients was significantly different within the highest SES quartile (OR = 0.44, P < 0.001), but not within the lowest. CONCLUSION In NYC, patients from higher SES quartile neighborhoods had significantly increased odds for receipt of PN for LRMs. As neighborhood SES quartile increased, White patients were significantly more likely to receive PN, while Black patients were not.
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Affiliation(s)
- Brendan K Wallace
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY
| | - Caleb H Miles
- Department of Biostatistics, Mailman School of Public Health, Columbia University, NY
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Clinical characteristics of renal cell carcinoma in patients under the age of 40. Urol Oncol 2021; 39:438.e23-438.e30. [PMID: 34103226 DOI: 10.1016/j.urolonc.2021.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/16/2021] [Accepted: 04/08/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Renal cell carcinoma (RCC) most commonly afflicts older patients while those 40 years old or younger represent an uncommon population. We aim to describe the tumor characteristics and treatment patterns for young kidney cancer patients utilizing the National Cancer Database. METHODS The National Cancer Database Participant User File for RCC was queried from 2004 to 2016. Demographics and treatment trends were analyzed and compared between a young cohort, those aged 40 and younger vs. a conventional cohort, those older than 40. Pathology analyzed included clear cell, papillary, chromophobe, RCC not otherwise specified, and miscellaneous uncategorized. Subanalysis was performed for patients with localized disease and treatment type. RESULTS Amongst the 514,879 patients diagnosed with RCC, 4.7% were ≤40 years old. RCC for individuals ≤40 has a higher proportion of female gender, non-Caucasian race, and chromophobe pathology, relative to the conventional cohort. Younger patients more often presented with cT1 disease with decreased rates of metastasis. Risk of 30-day readmission after surgery was similar between cohorts. For patients with cT1-2N0M0 disease, there was a decreasing rate of radical nephrectomy and increasing rate of partial nephrectomy; however, the conventional cohort had an increasing rate of percutaneous ablation while this remained stable in the younger cohort. CONCLUSION Young RCC patients had a higher proportion of female gender, chromophobe histology, and favorable tumor characteristics. Partial nephrectomy has seen a dramatic increase in application regardless of age while percutaneous ablation increased only in the conventional cohort.
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Sterling J, Rivera-Núñez Z, Patel HV, Farber NJ, Kim S, Radadia KD, Modi PK, Goyal S, Parikh R, Weiss RE, Kim IY, Elsamra SE, Jang TL, Singer EA. Factors Associated With Receipt of Partial Nephrectomy or Minimally Invasive Surgery for Patients With Clinical T1a and T1b Renal Masses: Implications for Regionalization of Care. Clin Genitourin Cancer 2020; 18:e643-e650. [PMID: 32389458 PMCID: PMC7502425 DOI: 10.1016/j.clgc.2020.03.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/14/2020] [Accepted: 03/16/2020] [Indexed: 01/20/2023]
Abstract
PURPOSE To identify factors associated with receipt of partial nephrectomy (PN) and minimally invasive surgery (MIS) in patients with clinical T1 renal cell carcinoma (RCC) using the National Cancer Data Base (NCDB). METHODS We queried the NCDB from 2010 to 2014 identifying patients treated surgically for cT1a-bN0M0 RCC. Logistic regression was used to examine associations between socioeconomic, clinical, and treatment factors, and receipt of MIS or PN within the T1 patient population. RESULTS Our cohort included 69,694 patients (cT1a, n = 44,043; cT1b, n = 25,651). For cT1a tumors, 70% of patients received PN and 65% underwent MIS. For cT1b tumors, 32% of patients received PN and 62% underwent MIS. cT1a and cT1b patients with household income < $62,000, without private insurance, and treated outside academic centers were less likely to receive MIS or PN. cT1a patients traveling > 31 miles were more likely to undergo MIS. For both cT1a/b, the farther a patient traveled for treatment, the more likely a PN was performed. CONCLUSION Data showed an increase in utilization of MIS and PN from 2010 to 2014. However, patients in the lowest socioeconomic groups were less likely to travel and were more likely to receive more invasive treatments. On the basis of these findings, additional research is needed into how regionalization of RCC surgery affects treatment disparities.
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Affiliation(s)
- Joshua Sterling
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Zorimar Rivera-Núñez
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ
| | - Hiren V Patel
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Nicholas J Farber
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Sinae Kim
- Division of Biometrics, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Kushan D Radadia
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Parth K Modi
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Sharad Goyal
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Rahul Parikh
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Robert E Weiss
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Isaac Y Kim
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Sammy E Elsamra
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Thomas L Jang
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Eric A Singer
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ.
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Liu X, Huang X, Zhao P, Zhang P. Survival benefit of nephron-sparing surgery for patients with pT1b renal cell carcinoma: A population-based study. Oncol Lett 2020; 19:498-504. [PMID: 31897163 DOI: 10.3892/ol.2019.11065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 04/15/2019] [Indexed: 02/05/2023] Open
Abstract
The use of partial nephrectomy (PN) to treat patients with large renal cell carcinoma (RCC) remains controversial, particularly among elderly patients. The present study compared the improvement in cancer-specific survival (CSS) in patients with pT1b RCC who underwent either PN or radical nephrectomy (RN) and investigated the effects of age and sex on CSS. A total of 20,343 patients were identified in the Surveillance, Epidemiology and End Results database. Kaplan-Meier curves and Cox regression analysis were used to compare the CSS of patients who received PN vs. those who received RN. In total, 5,375 (26.42%) and 14,968 (73.58%) patients with pT1b RCC received PN and RN, respectively. Kaplan-Meier and Cox regression analysis indicated that PN resulted in an improved CSS compared with RN (P<0.001). In addition, PN was observed to be beneficial in male (P<0.001) and female patients <75 years of age. However, it was not beneficial for female patients of ≥75 years of age (P=0.197). These preliminary results warrant further investigation in clinical trials.
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Affiliation(s)
- Xiaode Liu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.,Department of Radiation Oncology, Sichuan Cancer Center, Sichuan Cancer Hospital and Institute, School of Medicine University of Electronic Science and Technology of China, Chengdu, Sichuan 610041, P.R. China
| | - Xuemei Huang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.,Department of Radiation Oncology, Sichuan Cancer Center, Sichuan Cancer Hospital and Institute, School of Medicine University of Electronic Science and Technology of China, Chengdu, Sichuan 610041, P.R. China
| | - Pan Zhao
- Department of Radiation Oncology, Sichuan Cancer Center, Sichuan Cancer Hospital and Institute, School of Medicine University of Electronic Science and Technology of China, Chengdu, Sichuan 610041, P.R. China
| | - Peng Zhang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
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Is there a benefit to additional neuroaxial anesthesia in open nephrectomy? A prospective NSQIP propensity score analysis. Int Urol Nephrol 2019; 51:1481-1489. [PMID: 31222441 DOI: 10.1007/s11255-019-02208-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 06/13/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Neuroaxial (i.e., spinal, regional, epidural) anesthesia has been shown to be associated with reduced readmission rate, decreased hospital stay, and decreased overall complication rate in orthopedic and gynecologic surgery. Our aim was to identify differences in intra- and postoperative complications, length of stay and readmission rates in open nephrectomy patients managed with neuroaxial anesthesia. MATERIALS AND METHODS Utilizing National Surgical Quality Inpatient Program (NSQIP) database, we identified patients who have undergone an open nephrectomy between 2014 and 2017. Patients were further subdivided based on anesthesia modality. We used the propensity score-matching (PSM) method to adjust for baseline differences among patients who received general anesthesia alone and those with additional neuroaxial anesthesia. Using step-wise multivariable logistic regression, we identified preoperative and intraoperative predictors associated with 30-day procedure-related readmission, complications, and postoperative length of stay. RESULTS Out of 3,633 patients identified, 2346 patients met our inclusion and exclusion criteria. There was no difference in baseline characteristics after propensity score matching between general and additional neuroaxial anesthesia. Postoperative outcomes including: procedure-related readmission, rate of reoperation, operative time, all complications were similar between the groups. Adjuvant neuroaxial anesthesia group did experience a prolonged postoperative hospital stay that was statistically significant as compared to patients with general anesthesia alone [5.3 (3.5) days vs 4.8 (2.9) days, p = 0.007]. Compared to GA alone after multivariable logistic regression, neuroaxial anesthesia was not statistically significant for readmission (p = 0.909), any complication (p = 0.505), but did showed increased odds ratio of prolonged postoperative stay [aOR 1.107, 95% CI 1.042-1.176, p = 0.001] after adjusting for multiple factors. CONCLUSION Using 2014-2017 NSQIP database, we were able to demonstrate no additional reduction in complication or readmission rate in patients with neuroaxial anesthesia as compared to general anesthesia alone. Furthermore, patients who did receive neuroaxial anesthesia experienced a longer postoperative course.
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Miller C, Raza SJ, Davaro F, May A, Siddiqui S, Hamilton ZA. Trends in the treatment of clinical T1 renal cell carcinoma for octogenarians: Analysis of the National Cancer Database. J Geriatr Oncol 2018; 10:285-291. [PMID: 30528544 DOI: 10.1016/j.jgo.2018.11.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 11/13/2018] [Accepted: 11/28/2018] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Treatment of renal cell carcinoma has evolved with emphasis on nephron preservation for small renal masses. Our objective was to evaluate the proportions of treatment types for octogenarians with clinical stage 1 renal cell carcinoma. MATERIALS AND METHODS The National Cancer Database was analyzed from 2004 to 2015. Patients with clinical stage 1, tumor size ≤ 7 cm, and age 80-89 years old were compared to a younger control arm of patients ≤ 70 years old. Treatment modality was categorized as radical nephrectomy (RN), partial nephrectomy (PN), percutaneous ablative therapy (PAT), and no treatment (NT). Primary outcome was treatment utilization over time using estimated annual percentage change (EAPC). Secondary outcomes included logistic regression for 30 day readmission after treatment and any definitive tumor treatment choice. RESULTS 18,903 octogenarians were identified and compared to a control of 142,179 patients ≤ 70 years old. Overall, NT (36%) was the most common modality for octogenarians while PN (44.8%) was most common for the control arm. Using EAPC for octogenarians, we found increases for PAT (7.1%), PN (2.8%), and NT (1.6%) but a decrease for RN (-4.6%). EAPC for the younger cohort noted increases for PAT (6.8%), PN (5.4%), and NT (4.4%) but a decrease for RN (-5.5%). CONCLUSION For octogenarians with stage 1 renal cell carcinoma, minimally invasive treatments are increasingly utilized, while RN is decreasing. Compared to a younger cohort, a greater proportion of octogenarians are receiving NT. These findings remain encouraging for appropriate treatment of localized disease in patients with advanced age.
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Affiliation(s)
- Caleb Miller
- Division of Urology, Department of Surgery, Saint Louis University, St Louis, MO, United States
| | - Syed J Raza
- Division of Urology, Department of Surgery, Saint Louis University, St Louis, MO, United States
| | - Facundo Davaro
- Division of Urology, Department of Surgery, Saint Louis University, St Louis, MO, United States
| | - Allison May
- Division of Urology, Department of Surgery, Saint Louis University, St Louis, MO, United States
| | - Sameer Siddiqui
- Division of Urology, Department of Surgery, Saint Louis University, St Louis, MO, United States
| | - Zachary A Hamilton
- Division of Urology, Department of Surgery, Saint Louis University, St Louis, MO, United States.
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White VM, Marco DJT, Bolton D, Papa N, Neale RE, Coory M, Davis ID, Wood S, Giles GG, Jordan SJ. Age at diagnosis and the surgical management of small renal carcinomas: findings from a cross-sectional population-based study. BJU Int 2018; 122 Suppl 5:50-61. [PMID: 30307688 DOI: 10.1111/bju.14585] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVES To describe the use of partial nephrectomy (PN) for patients with stage T1a renal cell carcinoma (RCC) by age group (<65 and ≥65 years) in two Australian states. MATERIALS AND METHODS All adults diagnosed with RCC in 2012 and 2013 were identified through population-based cancer registries in the Australian states of Queensland and Victoria. For each patient, research assistants extracted patient, tumour and treatment data from medical records. Percentages of patients treated by PN were determined for the two age groups. Multivariable logistic regression analyses examined factors associated with PN. Clinicians treating RCC were sent surveys to assess attitudes towards PN. RESULTS Data were collected on 956 patients (Victoria: n = 548; Queensland: n = 404) with stage T1a RCC. Of those undergoing surgery (n = 865), PN was more common for those aged <65 years (61%) than for those aged ≥65 years (44%), with this difference significant after adjusting for patient, tumour (odds ratio 0.50, 95% confidence interval 0.36-0.70). There were significant interactions between age and treatment centre volume (P < 0.05) and residential state (P < 0.05). PN was less likely for younger patients treated at lower-volume hospitals (<24 patients a year) but hospital volume was not associated with PN for older patients. PN was less likely for older patients in Queensland than Victoria. In multivariable analyses, age was not related to laparoscopic surgery. Queensland clinicians were less likely than those from Victoria to agree that PN was the treatment of choice for most T1aN0M0 tumours (P < 0.001). CONCLUSIONS In Australia, patients aged > 65 years with small renal cancers were less likely to be treated by PN than younger patients. The variation in the surgical procedure used to treat older T1a RCC patients by state and hospital volume indicates that better evidence is needed to direct practice in this area.
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Affiliation(s)
- Victoria M White
- Deakin University, Burwood, Vic., Australia.,Cancer Council Victoria, Melbourne, Vic., Australia
| | - David J T Marco
- Centre for Palliative Care, St Vincent's Hospital, Fitzroy, Vic., Australia.,University of Melbourne, Parkville, Vic., Australia
| | | | | | - Rachel E Neale
- QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia.,School of Public Health, The University of Queensland, Brisbane, Qld, Australia
| | | | - Ian D Davis
- Eastern Health Clinical School, Monash University, Box Hill, Vic, Australia.,Eastern Health, Box Hill, Vic, Australia
| | - Simon Wood
- Centre for Kidney Disease Research, Faculty of Medicine, University of Queensland, Brisbane, Qld, Australia.,Department of Urology, Princess Alexandra Hospital, Brisbane, Qld, Australia.,Translational Research Institute, Brisbane, Qld, Australia
| | - Graham G Giles
- Cancer Council Victoria, Melbourne, Vic., Australia.,University of Melbourne, Parkville, Vic., Australia
| | - Susan J Jordan
- QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia.,School of Public Health, The University of Queensland, Brisbane, Qld, Australia
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Penn DC, Baker M, Geiger AM, Harlan LC. Treatment and Survival Disparities in the National Cancer Institute's Patterns of Care Study (1987-2017). Cancer Invest 2018; 36:319-329. [PMID: 30136865 PMCID: PMC6295665 DOI: 10.1080/07357907.2018.1474894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 05/06/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Cancer health services research is a primary tool for analyzing the association between various factors, cancer health care delivery, and the resultant outcomes. To address disparities strategies must be developed to target factors that are related to differences in care; however, to date, most disparities studies have been descriptive. The primary objective was to describe cancer treatment and survival disparities in community oncology practice patterns found in the National Cancer Institute's population-based Patterns of Care (POC) Study (1987-2017). Secondarily, we compared POC findings to peer-reviewed literature. In POC data, older age was consistently associated with decreased odds of treatment and increased mortality. Interestingly, in contrast to current literature, few POC studies found race/ethnicity significantly predicted disparities. Cancer health disparities are complex; they are multifactorial, differ by cancer site and may wax and wane. The complexity supports the need for deeper understanding and targeted interventions to ensure equitable cancer care and outcomes.
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Affiliation(s)
- Dolly C. Penn
- National Cancer Institute/Division of Cancer Control and Population Sciences/Healthcare Delivery Research Program, 9609 Medical Center Drive Bethesda, Maryland 20892
| | - Melanie Baker
- National Cancer Institute/Division of Cancer Control and Population Sciences/Healthcare Delivery Research Program, 9609 Medical Center Drive Bethesda, Maryland 20892
| | - Ann M. Geiger
- National Cancer Institute/Division of Cancer Control and Population Sciences/Healthcare Delivery Research Program, 9609 Medical Center Drive Bethesda, Maryland 20892
| | - Linda C. Harlan
- National Cancer Institute/Division of Cancer Control and Population Sciences/Healthcare Delivery Research Program, 9609 Medical Center Drive Bethesda, Maryland 20892
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Haque W, Verma V, Lewis GD, Lo SS, Butler EB, Teh BS. Utilization of radiotherapy and stereotactic body radiation therapy for renal cell cancer in the USA. Future Oncol 2018. [PMID: 29527938 DOI: 10.2217/fon-2017-0536] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
AIM This study evaluated national practice patterns of cT1N0M0 renal cell cancer, with a focus on stereotactic body radiation therapy (SBRT) utilization. METHODS The National Cancer Database was queried (2004-2013) for patients with newly-diagnosed cT1a/bN0M0 renal cell cancer that received definitive treatment. Temporal trends in utilization were tabulated. RESULTS Altogether, 138,495 patients met inclusion criteria; 13,725 (9.9%) patients received ablative therapy, 57,924 (41.8%) partial nephrectomy, 67,168 (48.5%) radical nephrectomy and 308 (0.2%) external beam radiation therapy (EBRT). The proportion of EBRT that was SBRT increased substantially from 25% in 2004 to 95.4% in 2013, with a sharp inflection point from 2005 to 2006. CONCLUSION SBRT utilization has sharply risen over time; in most recent years, the vast majority of EBRT is delivered in the form of SBRT.
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Affiliation(s)
- Waqar Haque
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, TX 77030, USA
| | - Vivek Verma
- Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, PA 15212, USA
| | - Gary D Lewis
- Department of Radiation Oncology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Simon S Lo
- Department of Radiation Oncology, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - Edward Brian Butler
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, TX 77030, USA
| | - Bin S Teh
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, TX 77030, USA
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