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Oncologic Outcomes in Young Adults With Kidney Cancer Treated During the Targeted Therapy Era
Pablo S Sierra1, Maurício D Cordeiro1, Emanuel V Albuquerque1
1Department of Urologic Oncology, Faculdade de Medicina Universidade de São Paulo, São Paulo, Brazil; Department of Urologic Oncology, Instituto do Câncer do Estado do São Paulo ICESP, São Paulo, Brazil.
Background:
The objective of this study was to determine the outcomes of young adults with kidney cancer treated during the targeted therapy era and evaluate the impact of young age on survival.
Materials And Methods:
We reviewed the records from 445 patients younger than 55 years with kidney cancer at a single institution from 2006 to 2017. Overall survival (OS) and recurrence-free survival were estimated with the Kaplan-Meier method and log-rank test. Cox proportional hazards regression was used to determine the impact of clinical and pathologic variables on all-cause mortality.
Results:
Overall, 104 (23%) patients 40 years or younger were compared with 341 (77%) patients who were 41 to 55 years old. Younger patients presented with more advanced stages of the disease, including metastasis at diagnosis, positive lymph nodes, venous tumor thrombus and had more non-clear cell tumors (54% vs. 30%; P < .001). Young adults had significantly worse OS at 2 and 5 years (67% vs. 82% and 53% vs. 69%, respectively). Younger patients with metastatic disease received targeted agents less often compared with the older group (64% vs. 75%). There was no difference in recurrence-free survival across patients with localized disease. Independent prognostic factors associated with increased mortality were metastasis at diagnosis, pT2 or greater, and age younger than 40 years (hazard ratio, 1.65; 95% confidence interval, 1.0-2.6; P = .03).
Conclusion:
Patients younger than 40 years with kidney tumors treated during the targeted therapy era have worse OS compared with older adults. Young age is an independent predictor of mortality.
Insights
Young adults under 40 with kidney cancer face worse survival outcomes. This study highlights young age as an independent predictor of mortality in kidney cancer patients during the targeted therapy era.
Area of Science:
- Oncology
- Urologic Oncology
- Cancer Epidemiology
Background:
- Kidney cancer (renal cell carcinoma) affects individuals across all age groups.
- The impact of young age on kidney cancer outcomes during the targeted therapy era is not well-defined.
- Understanding age-related disparities in cancer treatment and survival is crucial for personalized medicine.
Purpose of the Study:
- To determine the clinical outcomes of young adults diagnosed with kidney cancer.
- To evaluate the specific impact of young age as a prognostic factor for survival in kidney cancer patients.
- To analyze survival trends in kidney cancer patients treated during the targeted therapy period.
Main Methods:
- Retrospective review of 445 kidney cancer patients under 55 years old treated between 2006 and 2017.
- Kaplan-Meier analysis and log-rank tests to estimate overall survival (OS) and recurrence-free survival (RFS).
- Cox proportional hazards regression to identify independent prognostic factors for all-cause mortality.
Main Results:
- Patients aged 40 or younger (23%) presented with more advanced disease, including metastasis and non-clear cell histology, compared to older patients (41-55 years).
- Younger patients (under 40) exhibited significantly worse OS at 2 and 5 years.
- Age younger than 40 was identified as an independent predictor of mortality (HR, 1.65; P = .03), alongside metastasis at diagnosis and advanced tumor stage (pT2+).
Conclusions:
- Younger kidney cancer patients (<40 years) experience poorer overall survival compared to older adults, even within the targeted therapy era.
- Young age is a significant, independent risk factor for mortality in kidney cancer.
- Further research into age-specific treatment strategies and biological differences in young-onset kidney cancer is warranted.
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