title: Overall survival in renal cell carcinoma after introduction of targeted therapies: a Norwegian population-based study.
abstract: BACKGROUND
  This population-wide retrospective, non-interventional registry study assessed changes in overall survival (OS) and factors influencing OS in Norwegian patients with renal cell carcinoma (RCC).
  
  
  METHODS
  Two population-wide health registries were used to identify all RCC patients with (mRCC) or without metastases diagnosed before (2002-2005) and after (2006-2008 and 2009-2011) introduction of targeted therapies. Median OS was estimated using Kaplan-Meier method. Cox proportional hazards regression modeling was used to identify prognostic factors.
  
  
  RESULTS
  Overall, 5,463 patients were diagnosed with RCC during 2002-2005 (n=1,898), 2006-2008 (n=1,631), and 2009-2011 (n=1,934); of these, 1,678 (31%) had mRCC. Patients diagnosed in 2009-2011 and 2006-2008 had significant (P<0.001) improvements in OS versus those diagnosed in 2002-2005: median OS, not reached and not reached versus 82.0 months in RCC; 14.0 and 12.0 months versus 9.0 months in mRCC. Similarly, OS improvements were seen in the primary and elderly (≥75 years) mRCC populations. Median OS was comparable (12 months) between clear cell and papillary mRCC, but it was longer (24.0 months) for chromophobe mRCC. Multivariate regression analyses showed that younger age, previous nephrectomy, and 1 or more prescriptions of targeted therapy were significantly associated with longer OS in mRCC patients.
  
  
  CONCLUSIONS
  OS increased in RCC and mRCC patients in Norway between 2002 and 2011 following introduction of targeted therapies.
authors.affiliation: Department of Urology, Haukeland University Hospital; Department of Clinical Medicine, University of Bergen, Bergen.
authors.forename: Christian
authors.initials: C
authors.lastname: Beisland
authors.affiliation: Department of Registration, Cancer Registry of Norway, Oslo.
authors.forename: Tom B
authors.initials: TB
authors.lastname: Johannesen
authors.affiliation: Department of Oncology, Ålesund Hospital, Ålesund.
authors.forename: Olbjorn
authors.initials: O
authors.lastname: Klepp
authors.affiliation: Department of Pathology, Oslo University Hospital, the Norwegian Radium Hospital, Oslo.
authors.forename: Ulrika
authors.initials: U
authors.lastname: Axcrona
authors.affiliation: Pfizer AS, Oslo, Norway.
authors.forename: Knut Martin
authors.initials: KM
authors.lastname: Torgersen
authors.affiliation: JK Biostatistics AB, Stockholm.
authors.forename: Jan
authors.initials: J
authors.lastname: Kowalski
authors.affiliation: Pfizer AS, Oslo, Norway.
authors.forename: Oddvar
authors.initials: O
authors.lastname: Solli
authors.affiliation: Pfizer AB, Sollentuna, Sweden.
authors.forename: Rickard
authors.initials: R
authors.lastname: Sandin
authors.affiliation: Department of Oncology, Akershus University Hospital, Lørenskog; Medical Faculty, University of Oslo, Oslo, Norway.
authors.forename: Jan
authors.initials: J
authors.lastname: Oldenburg
keywords: Norway; nephrectomy; overall survival; renal cell carcinoma; targeted therapy