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Factors impacting survival in children with renal cell carcinoma
Kristy L Rialon1, Brian C Gulack1, Brian R Englum1
1Department of Surgery, Division of General Surgery, Duke University Medical Center, Durham, NC, 27710, USA.
Insights
Pediatric renal cell carcinoma (RCC) outcomes show excellent survival with surgery. Key factors influencing survival in children with kidney cancer include pathologic stage, tumor size, and nodal status.
Area of Science:
- Pediatric Oncology
- Urologic Oncology
- Cancer Epidemiology
Background:
- Renal cell carcinoma (RCC) is rare in children.
- Understanding outcomes and survival factors is crucial for pediatric kidney cancer patients.
Purpose of the Study:
- To analyze outcomes for children diagnosed with renal cell carcinoma (RCC).
- To identify variables impacting long-term survival in pediatric kidney cancer.
Main Methods:
- Utilized the National Cancer Data Base (NCDB) for patients aged 0-17 years diagnosed between 1998-2011.
- Evaluated patient demographics, tumor characteristics, stage, management, and survival outcomes.
Main Results:
- 304 children with RCC were analyzed; 39% had stage I, 16% stage II, 33% stage III, and 12% stage IV.
- Overall 1- and 5-year survival rates were 87% and 70%.
- Surgical resection, particularly partial nephrectomy, was associated with excellent survival (100% at 1 and 5 years). Survival was negatively impacted by larger tumor size, positive nodal status, and higher pathologic stage.
Conclusions:
- Surgical resection in children with renal cell carcinoma (RCC) leads to excellent survival rates.
- Pathologic stage, tumor size, and nodal status are significant predictors of survival in pediatric kidney cancer.
Purpose:
Renal cell carcinoma (RCC) is an uncommon tumor in the pediatric population. We examined a large national cancer database to determine outcomes for children with RCC and to identify variables affecting long-term survival.
Methods:
The National Cancer Data Base (NCDB) was queried for patients age 0 to 17 years diagnosed with RCC from 1998-2011. Patient demographics, tumor stage and characteristics, management, and outcomes were evaluated.
Results:
A total of 304 children met inclusion criteria. Overall, 39% of children had stage I disease, 16% stage II, 33% stage III, and 12% stage IV. One-year and five-year survival for all children was 87% and 70%, respectively. Eighty-six percent of patients underwent surgical resection. In comparison to children who underwent complete nephrectomy, patients undergoing partial nephrectomy had smaller tumors and were of lower clinical stages. Survival following partial resection was 100% at one and five years. Age and gender had no significant impact on survival. Survival was negatively impacted by increasing tumor size (P<0.001), positive nodal status (P=0.001), and higher pathologic stage (P<0.001).
Conclusion:
Children with renal cell carcinoma who undergo surgical resection have excellent one-year and five-year survival. Overall survival is significantly affected by pathologic stage, tumor size, and nodal status.
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