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Abstract：
UNASSIGNED: As the survival rates of patients with renal cell carcinoma (RCC) continue to increase, noncancer causes of death cannot be ignored. The cause-specific mortality in patients with RCC is not well understood.
UNASSIGNED: Our study aimed to explore the mortality patterns of contemporary RCC survivors.
UNASSIGNED: We performed a retrospective cohort study involving patients with RCC from the Surveillance, Epidemiology, and End Results (SEER) database. We used standardized mortality ratios (SMRs) to compare the death rates in patients with RCC with those in the general population.
UNASSIGNED: A total of 106,118 patients with RCC, including 39,630 who died (27%), were included in our study. Overall, compared with the general US population, noncancer SMRs were increased 1.25-fold (95% confidence intervals [CI], 1.22 to 1.27; observed, 11,235), 1.19-fold (95% CI, 1.14 to 1.24; observed, 2,014), and 2.24-fold (95% CI, 2.11 to 2.38; observed, 1,110) for stage I/II, III, and IV RCC, respectively. The proportion of noncancer causes of death increased with the extension of survival time. A total of 4,273 men with stage I/II disease (23.13%) died of RCC; however, patients who died from other causes were 3.2 times more likely to die from RCC (n = 14,203 [76.87%]). Heart disease was the most common noncancer cause of death (n = 3,718 [20.12%]; SMR, 1.23; 95% CI, 1.19-1.27). In patients with stage III disease, 3,912 (25.98%) died from RCC, and 2,014 (13.37%) died from noncancer causes. Most patients (94.99%) with stage IV RCC died within 5 years of initial diagnosis. Although RCC was the leading cause of death (n = 12,310 [84.65%]), patients with stage IV RCC also had a higher risk of noncancer death than the general population (2.24; 95% CI, 2.11-2.38).
UNASSIGNED: Non-RCC death causes account for more than 3/4 of RCC survivors among patients with stage I/II disease. Patients with stage IV are most likely to die of RCC; however, there is an increased risk of dying from septicemia, and suicide cannot be ignored. These data provide the latest and most comprehensive assessment of the causes of death in patients with RCC.
UNASSIGNED: Our study aimed to explore the mortality patterns of contemporary RCC survivors.
UNASSIGNED: We performed a retrospective cohort study involving patients with RCC from the Surveillance, Epidemiology, and End Results (SEER) database. We used standardized mortality ratios (SMRs) to compare the death rates in patients with RCC with those in the general population.
UNASSIGNED: A total of 106,118 patients with RCC, including 39,630 who died (27%), were included in our study. Overall, compared with the general US population, noncancer SMRs were increased 1.25-fold (95% confidence intervals [CI], 1.22 to 1.27; observed, 11,235), 1.19-fold (95% CI, 1.14 to 1.24; observed, 2,014), and 2.24-fold (95% CI, 2.11 to 2.38; observed, 1,110) for stage I/II, III, and IV RCC, respectively. The proportion of noncancer causes of death increased with the extension of survival time. A total of 4,273 men with stage I/II disease (23.13%) died of RCC; however, patients who died from other causes were 3.2 times more likely to die from RCC (n = 14,203 [76.87%]). Heart disease was the most common noncancer cause of death (n = 3,718 [20.12%]; SMR, 1.23; 95% CI, 1.19-1.27). In patients with stage III disease, 3,912 (25.98%) died from RCC, and 2,014 (13.37%) died from noncancer causes. Most patients (94.99%) with stage IV RCC died within 5 years of initial diagnosis. Although RCC was the leading cause of death (n = 12,310 [84.65%]), patients with stage IV RCC also had a higher risk of noncancer death than the general population (2.24; 95% CI, 2.11-2.38).
UNASSIGNED: Non-RCC death causes account for more than 3/4 of RCC survivors among patients with stage I/II disease. Patients with stage IV are most likely to die of RCC; however, there is an increased risk of dying from septicemia, and suicide cannot be ignored. These data provide the latest and most comprehensive assessment of the causes of death in patients with RCC.
摘要：
■随着肾细胞癌（RCC）患者的生存率不断提高，非癌症死亡原因不容忽视。肾癌患者的病因特异性死亡率尚不清楚。
■我们的研究旨在探索当代RCC幸存者的死亡模式。
■我们进行了一项回顾性队列研究，流行病学,和结束结果(SEER)数据库。我们使用标准化死亡率（SMR）来比较RCC患者与普通人群的死亡率。
■共有106,118例肾癌患者,包括39630人死亡(27%)，包括在我们的研究中。总的来说,与普通美国人口相比，非癌SMR增加1.25倍(95%置信区间[CI]，1.22至1.27；观察到，11,235)，1.19倍(95%CI，1.14至1.24；观察到，2,014),和2.24倍(95%CI，2.11至2.38；观察到，1,110）对于阶段I/II，III,和IVRCC，分别。随着生存时间的延长，非癌症死亡原因的比例增加。共有4,273名I/II期患者（23.13%）死于RCC；死于其他原因的患者死于RCC的可能性是其3.2倍(n=14,203[76.87%]).心脏病是最常见的非癌症死亡原因(n=3,718[20.12%];SMR,1.23；95%CI，1.19-1.27）。在III期疾病患者中，3,912（25.98%）死于RCC，2,014（13.37%）死于非癌症。大多数IV期RCC患者（94.99%）在初次诊断后5年内死亡。尽管RCC是导致死亡的主要原因（n=12,310[84.65％]），IV期RCC患者的非癌症死亡风险也高于一般人群(2.24;95%CI,2.11~2.38).
■在I/II期患者中，非RCC死亡原因占RCC幸存者的3/4以上。IV期患者最有可能死于RCC；然而，死于败血症的风险增加,自杀是不容忽视的。这些数据为RCC患者的死亡原因提供了最新，最全面的评估。
■我们的研究旨在探索当代RCC幸存者的死亡模式。
■我们进行了一项回顾性队列研究，流行病学,和结束结果(SEER)数据库。我们使用标准化死亡率（SMR）来比较RCC患者与普通人群的死亡率。
■共有106,118例肾癌患者,包括39630人死亡(27%)，包括在我们的研究中。总的来说,与普通美国人口相比，非癌SMR增加1.25倍(95%置信区间[CI]，1.22至1.27；观察到，11,235)，1.19倍(95%CI，1.14至1.24；观察到，2,014),和2.24倍(95%CI，2.11至2.38；观察到，1,110）对于阶段I/II，III,和IVRCC，分别。随着生存时间的延长，非癌症死亡原因的比例增加。共有4,273名I/II期患者（23.13%）死于RCC；死于其他原因的患者死于RCC的可能性是其3.2倍(n=14,203[76.87%]).心脏病是最常见的非癌症死亡原因(n=3,718[20.12%];SMR,1.23；95%CI，1.19-1.27）。在III期疾病患者中，3,912（25.98%）死于RCC，2,014（13.37%）死于非癌症。大多数IV期RCC患者（94.99%）在初次诊断后5年内死亡。尽管RCC是导致死亡的主要原因（n=12,310[84.65％]），IV期RCC患者的非癌症死亡风险也高于一般人群(2.24;95%CI,2.11~2.38).
■在I/II期患者中，非RCC死亡原因占RCC幸存者的3/4以上。IV期患者最有可能死于RCC；然而，死于败血症的风险增加,自杀是不容忽视的。这些数据为RCC患者的死亡原因提供了最新，最全面的评估。
