The National Cancer Data Base: report on kidney cancers. The American College of Surgeons Commission on Cancer and the American Cancer Society.
BACKGROUND
The National Cancer Data Base (NCDB) examining current time trends (1993) in stage of disease, treatment patterns, and survival of patients with kidney cancer are reported.


METHODS
Five calls for data have yielded a total of 3,700,000 cancer cases for the years 1985 through 1993, including 8140 kidney cancer cases in 1988 and 10,617 in 1993 from hospital cancer registries across the U.S. These data represent 36% and 39% of all cases of kidney cancers diagnosed in the U.S. in 1988 and 1993, respectively.


RESULTS
Three trends were observed. 1) Stage II disease is being diagnosed with increasing frequency. 2) There has been an overall increase in the frequency with which surgery alone is utilized as the primary treatment for patients with Stage I, II, and III disease; however, surgical treatment of patients with Stage IV kidney cancer has declined. 3) Partial nephrectomy rather than total nephrectomy is performed with increasing frequency as surgical treatment of patients with Stage I renal carcinoma.


CONCLUSIONS
The NCDB data have important implications for analyzing cancer treatments and outcomes in the U.S. These data suggest that kidney cancers are being diagnosed at an earlier stage and with greater precision. As a result, changes in surgical practice are apparent in the treatment of patients with lower stage disease (Stage I and II). Stage for stage, surgery remains the most effective form of treatment for patients with kidney cancer.
Marshall
F F
FF
Department of Urology, Johns Hopkins Hospital, Baltimore, Maryland, USA.
Stewart
A K
AK
Menck
H R
HR
D000368:Aged; D000369:Aged, 80 and over; D000570:American Cancer Society; D003131:Combined Modality Therapy; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods; D012955:Societies, Medical; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States