title: Treatment and overall survival in renal cell carcinoma: a Swedish population-based study (2000-2008).
abstract: BACKGROUND
  This retrospective register study assessed overall survival (OS) and influential factors on OS in Swedish renal cell carcinoma (RCC) patients.
  
  
  METHODS
  Using three merged national health registers, Cox proportional-hazards analysis was conducted and, in three models, it was used to assess the impact of cytokine (interferon-α and tyrosine kinase inhibitor (TKI; sunitinib or sorafenib) treatment on OS in metastatic (m)RCC.
  
  
  RESULTS
  From 2000 to 2008, 8009 patients were diagnosed with RCC and 2753 with mRCC (2002-2008). Median OS in RCC patients diagnosed from 2006 to 2008 compared with 2000-2005 was not reached vs 47.9 months (P<0.001), and in mRCC patients diagnosed from 2006 to 2008 compared with 2002-2005, was 12.4 vs 9.6 months, respectively (P=0.004). Factors associated with significantly improved OS in RCC were female gender, lower age, and previous nephrectomy, and, in mRCC female gender, previous nephrectomy, and any TKI prescription (Model 1: median-adjusted OS, 19.4 months (TKI patients) vs 9.7 months (non-TKI patients); hazard ratio, 0.621; P<0.001).
  
  
  CONCLUSIONS
  OS was improved in Swedish patients diagnosed with RCC and mRCC in the period 2006-2008 compared with 2000-2005 (RCC) and 2002-2005 (mRCC). Although multifactorial in origin, results suggest that increased nephrectomy rates and the use of TKIs contributed to the improvement seen in mRCC patients.
authors.affiliation: Pfizer AB, Vetenskapsvägen 10, Sollentuna 191 90, Sweden. thomas.wahlgren@pfizer.com
authors.forename: T
authors.initials: T
authors.lastname: Wahlgren
authors.forename: U
authors.initials: U
authors.lastname: Harmenberg
authors.forename: P
authors.initials: P
authors.lastname: Sandström
authors.forename: S
authors.initials: S
authors.lastname: Lundstam
authors.forename: J
authors.initials: J
authors.lastname: Kowalski
authors.forename: M
authors.initials: M
authors.lastname: Jakobsson
authors.forename: R
authors.initials: R
authors.lastname: Sandin
authors.forename: B
authors.initials: B
authors.lastname: Ljungberg
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000401:mortality*; D005260:Female; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000401:mortality*; D008297:Male; D016016:Proportional Hazards Models; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D012042:Registries; D012189:Retrospective Studies; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D016898:Interferon-alpha; D047428:Protein Kinase Inhibitors