Should stage III renal cell carcinoma with pN1 be classified as stage IV of the American Joint Committee on Cancer classification? A RECUR external validation

2019 ◽  
Vol 18 (1) ◽  
pp. e1170
Author(s):  
S. Dabestani ◽  
C. Beisland ◽  
G.D. Stewart ◽  
U. Capitanio ◽  
P. Järvinen ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
External Validation ◽  
Stage Iv ◽  
Cancer Classification ◽  
Stage Iii ◽  
American Joint Committee

Factors associated with palliative care (PC) utilization in advanced and metastatic renal cell carcinoma (RCC).

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 297-297
Author(s):  
Hiren V. Patel ◽  
Joshua Sterling ◽  
Arnav Srivastava ◽  
Sinae Kim ◽  
Biren Saraiya ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Palliative Care ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Multivariable Analysis ◽  
Stage Iv ◽  
Stage Iii ◽  
Clinical Factors ◽  
Factors Associated ◽  
To Receive

297 Background: Palliative care (PC) offers various benefits for patient with cancer that include, but are not limited to, decrease in disease-specific symptoms and improvement in functional status. Several oncological guidelines have adopted early integration of PC into oncologic care to improve quality of life among patients with advanced malignancies. However, PC utilization patterns and factors associated with its use in advanced renal cell carcinoma (RCC) remain poorly understood. Methods: Using the National Cancer Database (NCDB), we abstracted patients with stage III and IV RCC from 2004-2014 and evaluated PC utilization amongst this cohort. Socioeconomic and clinical factors were compared for patient receiving and not receiving PC for advanced RCC. Multivariable logistic regression identified factors that were associated with receipt of PC. Results: We identified 20,122 and 42,014 patients with stage III and IV RCC, respectively. Among this cohort, 329 and 9,317 patients received PC for stage III and IV RCC, respectively. From 2004 to 2014, PC utilization has been stable at ~1% for stage III RCC and has significantly increased from 17% to 20% for stage IV RCC. Multivariable analysis demonstrated that Blacks, income >$48,000, regions outside of Northeast, stage III RCC, and patients that received surgery were less likely to receive PC. Patients that were female, with more comorbidities, uninsured or with government insurance, lower educational status, treated at academic or integrated cancer program, with sarcomatoid histology, receiving systemic therapy were more likely to receive PC. Conclusions: While PC utilization has significantly increased for stage IV RCC, there are several demographic, socioeconomic, and clinical factors that predict PC usage among patients with advanced RCC. Taken together, this suggests the need for more equitable and systematic use of PC among patients with advanced RCC.

Factors associated with palliative care utilization in advanced and metastatic renal cell carcinoma.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 146-146
Author(s):  
Hiren V. Patel ◽  
Joshua Sterling ◽  
Arnav Srivastava ◽  
Sinae Kim ◽  
Biren Saraiya ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Palliative Care ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Stage Iv ◽  
Stage Iii ◽  
Care Utilization ◽  
Clinical Factors ◽  
Factors Associated ◽  
Specific Manner

146 Background: Palliative care (PC) offers various benefits for patient with cancer that include, but are not limited to, decrease in disease-specific symptoms and improvement in functional status. Several oncological guidelines have adopted early integration of PC into oncologic care to improve quality of life among patients with advanced malignancies. However, PC utilization patterns and factors associated with its use in advanced renal cell carcinoma (RCC) remain poorly understood. Methods: Using the National Cancer Database (NCDB), we abstracted patients with Stage III and IV RCC from 2004-2014 and evaluated PC utilization amongst this cohort. Socioeconomic and clinical factors were compared for patient receiving and not receiving PC for advanced RCC. Multivariable logistic regression identified factors that were associated with receipt of PC among the overall cohort and treatment-based cohorts. Results: Among 20,122 and 42,014 patients with Stage III and IV RCC, 329 and 9,317 patients received PC, respectively. From 2004 to 2014, PC utilization was stable at ̃1% for Stage III RCC and minimally increased from 17% to 20% for Stage IV RCC. Multivariable analysis demonstrated that increased comorbidities, insurance status, higher education status, facility location, care at a comprehensive cancer program or integrated network, sarcomatoid histology, and prior treatments significantly increased likelihood of palliative care utilization. We uncover socioeconomic and clinical factors that are associated with receipt of palliative care use in a treatment-specific manner. Conclusions: While PC utilization has minimally increased for Stage IV RCC, there are several demographic, socioeconomic, and clinical factors that predict PC use, especially in a treatment-specific manner, among patients with advanced RCC. Taken together, this suggests the need for more equitable and systematic use of PC among patients with advanced RCC.

scholarly journals External validation of a predictive model of survival after cytoreductive nephrectomy for metastatic renal cell carcinoma

2018 ◽  
Vol 36 (12) ◽  
pp. 1973-1980 ◽  
Author(s):  
Lorenzo Marconi ◽  
Roderick de Bruijn ◽  
Erik van Werkhoven ◽  
Christian Beisland ◽  
Kate Fife ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Predictive Model ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
External Validation ◽  
Cytoreductive Nephrectomy

1020 Clinical variables for predicting stage IV renal cell carcinoma patients who will not benefit from cytoreductive nephrectomy

2012 ◽  
Vol 11 (1) ◽  
pp. e1020-e1020a
Author(s):  
Y. Ohno ◽  
J. Nakashima ◽  
M. Ohori ◽  
H. Okubo ◽  
K. Shimodaira ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Stage Iv ◽  
Cytoreductive Nephrectomy ◽  
Clinical Variables

scholarly journals Determinants of treatment in patients with stage IV renal cell carcinoma

BMC Urology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Christopher S. Hollenbeak ◽  
Eric W. Schaefer ◽  
Justin Doan ◽  
Jay D. Raman
Keyword(s):  
Renal Cell Carcinoma ◽  
Elderly Patients ◽  
Cell Carcinoma ◽  
Systemic Therapy ◽  
Renal Cell ◽  
Stage Iv ◽  
Data Set ◽  
Causes Of Mortality ◽  
Competing Causes ◽  
Metastatic Rcc

Abstract Background Advances in systemic targeted therapies afford treatment opportunities in patients with metastatic renal cell carcinoma (RCC). Elderly patients with metastatic RCC present a subpopulation for consideration owing to competing causes of mortality and benefits seen with new therapeutic agents. We investigate treatment patterns for elderly patients with stage IV RCC and determine factors associated with not receiving treatment. Methods The Surveillance Epidemiology and End Results (SEER) Medicare linked data set contained 949 stage IV RCC patients over age 65 diagnosed between 2007 and 2011. Treatment approach was modeled using multinomial logistic regression. Landmark analysis at 6 months accounted for early death as a potential explanation for no treatment. Results Of the 949 patients with stage IV RCC, 26.2% received surgery and 34.1% received systemic therapy within 6 months of diagnosis. Among our entire cohort, over half (51.2%) had no evidence of receiving surgery or systemic therapy. Among the 447 patients who survived at least 6 months, 26.6% did not receive treatment during this time. Older patients and those with a higher Charlson Comorbidity Index (CCI) had lower odds of being treated with surgery, systemic therapy, or both. Conversely, married patients had higher odds of receiving these therapies. These associations were largely sustained in the 6-month landmark analyses. Conclusions Elderly patients with metastatic RCC present a unique subpopulation for consideration owing to competing causes of mortality. Many elderly patients with stage IV RCC did not receive surgery or systemic therapy up to 6 months from diagnosis. Several clinical and demographic factors were associated with this observation. Further investigation is needed to understand the rationale underlying the underutilization of systemic therapy in elderly patients.

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