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Evaluation of the prognostic role of co-morbidities on disease outcome in renal cell carcinoma patients

  • Johannes Heide
  • Silvia Ribback
  • Tobias Klatte
  • Shahrokh Shariat
  • Martin Burchardt
  • Frank Dombrowski
  • Arie S. Belldegrun
  • Alexandra Drakaki
  • Allan J. Pantuck
  • Nils KroegerEmail author
Original Article
  • 2 Downloads

Abstract

Background

Co-morbidities may induce local and systemic tumor progression of renal cell carcinoma (RCC); however, the prognostic impact of co-morbidities has not yet been well characterized.

Patients and methods

RCC patients (n = 2206) surgically treated at three academic institutions in the US and Europe were included in the analysis. Presence of diabetes mellitus, hypertension, chronic kidney disease, chronic obstructive pulmonary disease, coronary heart disease, and hypothyroidism were investigated for their association with clinicopathological features and cancer-specific survival.

Results

Hypertension was associated with less advanced T stages (p = 0.025), a lower risk of lymph-node (p = 0.026) and distant metastases (p = 0.001), and improved cancer specific survival in univariable analysis (HR 0.81 95% CI 0.69–0.96, p = 0.013). However, hypertension was not an independent prognostic factor after adjustment for TNM stages, grading, and ECOG performance status (HR 0.95, 95% CI 0.80–1.12; p = 0.530). A correlation between the use of concomitant anti-hypertensive medications and improved survival outcome was not identified. All other investigated co-morbidities did not show significant associations with clinicopathological features or cancer-specific survival.

Conclusion

Although the investigated co-morbidities are capable or inducing pathophysiological changes that are predisposing factors for tumor progression, none is an independent prognostic factor in patients with RCC.

Keywords

Renal cell carcinoma Co-morbidities Hypertension Co-morbidities Anti-hypertensive medication Statins Prognostic factors 

Notes

Author contributions

Study design: NK, TK, and AJP. Writing of the manuscript: JH, TK, AJP, and NK. Statistical analyses: NK and TK. Data interpretation: all authors. Collection of data: all authors. Interpretation of analyses: all authors. Approval of the manuscript: all authors.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Supplementary material

345_2019_2930_MOESM1_ESM.docx (128 kb)
Supplementary material 1 (DOCX 128 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Johannes Heide
    • 1
  • Silvia Ribback
    • 5
  • Tobias Klatte
    • 2
    • 3
    • 4
  • Shahrokh Shariat
    • 2
  • Martin Burchardt
    • 1
  • Frank Dombrowski
    • 5
  • Arie S. Belldegrun
    • 6
  • Alexandra Drakaki
    • 6
    • 7
  • Allan J. Pantuck
    • 6
  • Nils Kroeger
    • 1
    Email author
  1. 1.Department of UrologyUniversity Medicine at the Ernst-Moritz-Arndt-University Greifswald, F. Sauerbruch StrGreifswaldGermany
  2. 2.Department of UrologyMedical University of ViennaViennaAustria
  3. 3.Department of SurgeryUniversity of CambridgeCambridgeUK
  4. 4.Department of UrologyRoyal Bournemouth and Christchurch Hospitals National Health Services DorsetBournemouthUK
  5. 5.Institute of PathologyUniversity Medicine at the Ernst-Moritz-Arndt-University GreifswaldGreifswaldGermany
  6. 6.Department of Urology at the David Geffen-School of Medicine, Institute of Urologic OncologyUniversity of California Los AngelesLos AngelesUSA
  7. 7.Division of Hematology/Oncology, Department of Medicine at the David Geffen-School of MedicineUniversity of California Los AngelesLos AngelesUSA

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