Young age as favorable prognostic factor for cancer-specific survival in localized renal cell carcinoma.
OBJECTIVE
To evaluate the prognostic effect of age in patients with localized renal cell carcinoma (RCC) and investigate the incidence of Xp11 translocation RCC in young patients who developed recurrence.


METHODS
From 1990 to 2007, 2403 Japanese patients underwent nephrectomy for presumed RCC at 9 institutions. Of those, 1143 patients had localized RCC (Stage pT1-2N0M0). Their clinical data were retrospectively reviewed. In the present study, 131 patients (11%) were considered young (≤45 years at diagnosis). In the young patients with recurrence, the nephrectomy specimens were immunostained with TFE3 to determine the incidence of Xp11 translocation RCC.


RESULTS
During the median follow-up of 47 months, 3 cancer deaths (2.2%) occurred among young patients and 51 (5.0%) among older patients. The 5-year cancer-specific survival (CSS) rate was significantly better for the younger patients than for the older patients (P = .049). Multivariate analysis showed that age was significantly associated with CSS, as were the pathologic T stage, tumor grade, and symptoms at diagnosis. The hazard ratio of young age was 0.31 (95% confidence interval 0.077-0.87). The recurrence-free survival curves revealed no difference between these 2 groups. Of the 74 patients with recurrence, the CSS after recurrence was significantly better in the younger patients than in the older patients (P = .0010). Of the 8 young patients with recurrence, 4 had Xp11 translocation RCC, and 3 survived for >5 years after recurrence.


CONCLUSIONS
Compared with the older patients, the young patients with RCC had similar recurrence-free survival rates but better CSS rates. This might have been because significant numbers of the young patients had Xp11 translocation RCC.
Department of Urology, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.
Yoshinobu
Y
Komai
Yasuhisa
Y
Fujii
Yasumasa
Y
Iimura
Manabu
M
Tatokoro
Kazutaka
K
Saito
Yukihiro
Y
Otsuka
Fumitaka
F
Koga
Chizuru
C
Arisawa
Satoru
S
Kawakami
Tetsuo
T
Okuno
Toshihiko
T
Tsujii
Yukio
Y
Kageyama
Shinji
S
Morimoto
Tsuguhiro
T
Toma
Yotsuo
Y
Higashi
Iwao
I
Fukui
Kazunori
K
Kihara
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002292:Carcinoma, Renal Cell / Q000235:genetics / Q000401:mortality*; D002648:Child; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007680:Kidney Neoplasms / Q000235:genetics / Q000401:mortality*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000235:genetics; D011379:Prognosis; D012189:Retrospective Studies; D014178:Translocation, Genetic; D055815:Young Adult