Time trends in surgical provision and cancer-specific outcomes in patients with stage T2-3 kidney cancer: a SEER-based study

TL;DR

This study examines trends in kidney cancer surgeries and finds that partial nephrectomy is increasing and may improve survival outcomes.

Contribution

The study identifies a growing preference for partial nephrectomy in stage T2-3 kidney cancer and links it to better survival outcomes.

Findings

Partial nephrectomy usage increased annually by 7.0% (AAPC).

Patients with partial nephrectomy had better cancer-specific survival rates.

Radical nephrectomy remains the most common surgical method.

Abstract

Surgery is the primary therapy that crucially affects the survival of patients with kidney cancer (KC). However, pertinent surgical decision criteria for individuals with stage T2-3 KC are lacking. This study aimed to display the practical choices and evolving trends of surgical procedures and elucidate their implied value.

Through the Surveillance, Epidemiology, and End Results (SEER) dataset, the levels and evolving trends of different surgical methods were examined to determine cancer-specific risk of death (CSRD). Additionally, stratification analysis and survival rate analysis were performed to explore the effectiveness of partial nephrectomy (PN).

In this study, 9.27% of patients opted for PN. Interestingly, an upward trend was observed in its decision, with an average annual percentage change (AAPC) of 7.0 (95% CI: 4.8–9.3, P < 0.05). Patients who underwent PN and were in a relatively less severe condition exhibited more favorable CSRD levels (0.17–0.36 vs. 0.50–0.67) and an improvement trend compared with those who underwent radical nephrectomy (RN) (AAPC: −1.9 vs. −0.8). Further analysis showed that the levels of CSRD and survival rates for patients opting for different surgical methods followed a similar pattern.

This study showed that RN was still the most common surgical method. Patients with stage T2-3 KC had an increasing preference for PN and exhibited more favorable cancer-related survival outcomes, which underscores the need for further investigation and validation.

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