Abstract：
BACKGROUND: It is unknown whether the benefit from partial nephrectomy regarding lower other-cause mortality is applicable to older patients with metastatic renal cell carcinoma.
METHODS: Using Surveillance Epidemiology and End Results database, patients with metastatic renal cell carcinoma, undergoing partial or radical nephrectomy, were stratified according to age (<60, 60-69, and ≥70 years). After propensity score matching, Kaplan-Meier survival analyses and multivariable Cox regression models were used.
RESULTS: Of 2,390 patients with metastatic renal cell carcinoma, 885 (37%) were aged <60 years, and 90 (10%) underwent partial nephrectomy; 824 (34%) were aged 60-69 years, and 61 (7%) underwent partial nephrectomy; and 681 (29%) were aged ≥70 years, and 64 (9%) underwent partial nephrectomy. After propensity score matching, in patients aged <60 years, partial nephrectomy was associated with lower other-cause mortality (hazard ratio 0.22; p = 0.02); in patients aged 60-69 years, partial nephrectomy was associated with lower other-cause mortality (hazard ratio 0.38; p = 0.03); but not in patients aged ≥70 years.
CONCLUSIONS: In metastatic renal cell carcinoma, partial nephrectomy is associated with lower other-cause mortality in patients aged <60 years and in patients aged 60-69 years, but not in patients aged ≥70 years. In consequence, consideration of partial nephrectomy might be of great value in younger metastatic renal cell carcinoma patients.
METHODS: Using Surveillance Epidemiology and End Results database, patients with metastatic renal cell carcinoma, undergoing partial or radical nephrectomy, were stratified according to age (<60, 60-69, and ≥70 years). After propensity score matching, Kaplan-Meier survival analyses and multivariable Cox regression models were used.
RESULTS: Of 2,390 patients with metastatic renal cell carcinoma, 885 (37%) were aged <60 years, and 90 (10%) underwent partial nephrectomy; 824 (34%) were aged 60-69 years, and 61 (7%) underwent partial nephrectomy; and 681 (29%) were aged ≥70 years, and 64 (9%) underwent partial nephrectomy. After propensity score matching, in patients aged <60 years, partial nephrectomy was associated with lower other-cause mortality (hazard ratio 0.22; p = 0.02); in patients aged 60-69 years, partial nephrectomy was associated with lower other-cause mortality (hazard ratio 0.38; p = 0.03); but not in patients aged ≥70 years.
CONCLUSIONS: In metastatic renal cell carcinoma, partial nephrectomy is associated with lower other-cause mortality in patients aged <60 years and in patients aged 60-69 years, but not in patients aged ≥70 years. In consequence, consideration of partial nephrectomy might be of great value in younger metastatic renal cell carcinoma patients.
摘要：
背景：关于其他原因死亡率较低的肾部分切除术的益处是否适用于患有转移性肾细胞癌的老年患者尚不清楚。
方法：使用监测流行病学和最终结果数据库，转移性肾细胞癌患者，接受部分或根治性肾切除术，根据年龄（<60、60-69和≥70岁）进行分层。在倾向得分匹配后，使用Kaplan-Meier生存分析和多变量Cox回归模型。
结果：在2,390例转移性肾细胞癌患者中，885（37%）年龄<60岁，90例（10％）接受了部分肾切除术；824例（34％）年龄在60-69岁之间，61例（7%）接受了部分肾切除术；681例（29%）年龄≥70岁，64例(9%)行部分肾切除术。在倾向得分匹配后，年龄<60岁的患者，肾部分切除术与较低的其他原因死亡率相关（风险比0.22;p=0.02）；在60-69岁的患者中，肾部分切除术与较低的其他原因死亡率相关（风险比0.38；p=0.03）；但在年龄≥70岁的患者中没有。
结论：在转移性肾细胞癌中，在年龄<60岁的患者和60-69岁的患者中，肾部分切除术与其他原因死亡率较低相关。但不在年龄≥70岁的患者中。因此，对于年轻的转移性肾癌患者，考虑肾部分切除术可能具有重要价值。
方法：使用监测流行病学和最终结果数据库，转移性肾细胞癌患者，接受部分或根治性肾切除术，根据年龄（<60、60-69和≥70岁）进行分层。在倾向得分匹配后，使用Kaplan-Meier生存分析和多变量Cox回归模型。
结果：在2,390例转移性肾细胞癌患者中，885（37%）年龄<60岁，90例（10％）接受了部分肾切除术；824例（34％）年龄在60-69岁之间，61例（7%）接受了部分肾切除术；681例（29%）年龄≥70岁，64例(9%)行部分肾切除术。在倾向得分匹配后，年龄<60岁的患者，肾部分切除术与较低的其他原因死亡率相关（风险比0.22;p=0.02）；在60-69岁的患者中，肾部分切除术与较低的其他原因死亡率相关（风险比0.38；p=0.03）；但在年龄≥70岁的患者中没有。
结论：在转移性肾细胞癌中，在年龄<60岁的患者和60-69岁的患者中，肾部分切除术与其他原因死亡率较低相关。但不在年龄≥70岁的患者中。因此，对于年轻的转移性肾癌患者，考虑肾部分切除术可能具有重要价值。
