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An analysis of patients with T 2 renal cell carcinoma ( RCC ) according to tumour size: a population‐based analysis
Author(s) -
Bianchi Marco,
Becker Andreas,
Trinh QuocDien,
Abdollah Firas,
Tian Zhe,
Shariat Shahrokh F.,
Montorsi Francesco,
Perrotte Paul,
Graefen Markus,
Karakiewicz Pierre I.,
Sun Maxine
Publication year - 2013
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.12084
Subject(s) - renal cell carcinoma , proportional hazards model , medicine , linear discriminant analysis , nephrectomy , oncology , survival analysis , kidney cancer , population , carcinoma , regression , urology , statistics , kidney , mathematics , environmental health
Objective To examine the discriminant properties of the most contemporary version of the T umour‐ N ode‐ M etastasis ( TNM ) staging for renal cell carcinoma ( RCC ) sub‐classification of T 2 lesions according to a threshold size of 10 cm. Other thresholds were also assessed.Patients and Methods Between 1988 and 2006, within the Surveillance, Epidemiology, and End Results database, patients with T 2 N 0–2 M 0–1 RCC treated with a nephrectomy were abstracted. Tumour size was evaluated according to several thresholds: ≥8, ≥9, ≥10, ≥11, and ≥12 cm. Kaplan– M eier and life tables for cancer‐specific mortality ( CSM ) were computed. Several C ox regression modes were fitted for prediction of CSM , using different thresholds. The predictive accuracy of various thresholds was compared using the area under the curve and methods of calibration.Results In all, 4963 patients were identified. Kaplan– M eier analyses showed statistically significant CSM ‐free survival differences between all examined thresholds. In multivariable C ox‐regression models, all tested tumour size thresholds emerged as independent predictors of CSM . Of all thresholds, the values of 9 (0.55) and 11 cm (0.55) achieved the highest discrimination in univariable analysis, followed by 10 (0.539), 12 (0.539), and 8 cm (0.531). When the thresholds were combined with all other variables, the 11 cm (0.688) achieved the highest discrimination.Conclusion The discriminant properties of all examined thresholds showed very similar discriminant properties, which brings into questioning whether a dichotomization of pT2 tumours is really necessary.