Evaluation of the prognostic role of co-morbidities on disease outcome in renal cell carcinoma patients
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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.
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.
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.
KeywordsRenal cell carcinoma Co-morbidities Hypertension Co-morbidities Anti-hypertensive medication Statins Prognostic factors
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.
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