Disease-specific survival in patients with renal cell carcinoma: an audit of a large series from Korea.
BACKGROUND
To evaluate the question of whether or not young age is an independent prognostic factor for disease-specific survival in Korean patients with renal cell carcinoma.


METHODS
A total of 785 patients with an age range of 22-84 years (median, 56) were included in the study. Patients were categorized according to age; 40 years or less (n = 93), 41-60 years (n = 416) and older than 60 years (n = 276).


RESULTS
Patients 40 years or less at diagnosis differed significantly from older patients for the following parameters: smaller tumour diameter (P = 0.001), less advanced stage (P = 0.002), lower Fuhrman nuclear grade (P = 0.017) and fewer clear cell carcinomas (P < 0.001). Five-year disease-specific survival rate in patients 40 years or younger was also higher than that of older patients (92.7% versus 86.0% versus 69.2%; P < 0.001). When subgroup analysis was performed, only in patients with tumour diameter 4.1-7.0 cm (P = 0.018), pT1-pT2,N0,M0 (P = 0.001) or clear cell type carcinoma (P < 0.001), disease-specific survival probability for patients 40 years or younger was higher than that of older patients. When the Cox proportional hazards model was applied, age at diagnosis was not an independent prognostic predictor of disease-specific survival.


CONCLUSIONS
Tumours found in young adults show more favourable histological features than those found in older adults. However, according to results from multivariate analysis, young patients do not have higher disease-specific survival rate after adjusting for clinical and pathological variables.
Ku
Ja Hyeon
JH
Department of Urology, Seoul National University Hospital, 28, Yongon Dong, Jongno Ku, Seoul 110-744, South Korea.
Moon
Kyung Chul
KC
Kwak
Cheol
C
Kim
Hyeon Hoe
HH
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors