e16068 Background: Use of TKIs is standard of care for metastatic ccRCC and cytoreductive nephrectomy has improved survival even in metastatic ccRCC. The use of cytoreductive nephrectomy in the TKI era post-2005 for nccRCC histologies is unknown. We sought to determine trends and explore differences in characteristics of ccRCC and nccRCC, use of cytoreductive nephrectomy and survival outcomes for varying stages. Methods: Using a de-identified dataset acquired from the NCDB from 2004 to 2014, extraction of demographic information on patients divided into ccRCC versus nccRCC. Descriptive statistics was used for summarizing patients’ characteristics. Chi-Square test was used for comparing categorical variables. Two-sample t-test was used for comparing continuous variables. Kaplan-Meier method was used to analyze patients’ survival data. Results: 302,339 (82%) ccRCC and 66,530 (18%) nccRCC patients were identified. nccRCC included papillary (n = 42,251), sarcomatoid (n = 5769), chromophobe (n = 17,671) and collecting duct (n = 839). The median age for both groups was 63 years, more common in males (ccRCC = 61%; nccRCC = 69%), and mostly Caucasians (ccRCC = 86%; nccRCC = 75%). Most patients were treated in comprehensive community and academic research programs (ccRCC = 81%; nccRCC = 83%). Majority of patients were diagnosed with AJCC Stage I (ccRCC = 57%, nccRCC = 62%). Stage IV was diagnosed in 14% of ccRCC and 9% of nccRCC. The utilization of nephrectomy declined for ccRCC at 36% in the year 2014 compared to 44% in 2005, whereas it declined more for nccRCC with 47% in 2014 compared to 70% in 2005. The median survival time for Stage I was comparable in both groups (ccRCC = 140 mos, 95% CI 138.8 – 142.16; nccRCC = 140 mos, 95% CI 138 – unestimable). However, median survival was worse for stage IV in nccRCC (ccRCC = 9 mos; 95% CI 8.8 – 9.17; nccRCC = 7.43 mos; 95% CI 7.16 – 7.79). Conclusions: In stage IV patients with nccRCC, cytoreductive nephrectomy is used less often and overall survival appears inferior compared to ccRCC.
Frequency, incidence and survival outcomes of clear cell renal cell carcinoma in the United States from 1973 to 2014