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Original article

Vol. 152 No. 2324 (2022)

Incidence and outcome of patients with renal cell carcinoma treated with partial or radical nephrectomy in the Cantons St Gallen and Appenzell 2009–2018

  • Stefanie Aeppli
  • Daniel S. Engeler
  • Stefanie Fischer
  • Aurelius Omlin
  • Manolis Pratsinis
  • Christian Hermann
  • Christian Rothermundt
DOI
https://doi.org/10.4414/SMW.2022.w30175
Cite this as:
Swiss Med Wkly. 2022;152:w30175
Published
16.06.2022

Summary

BACKGROUND: Over recent years, the incidence of renal cell carcinoma (RCC) has remained unchanged in Switzerland and is low compared with other European countries. Partial or radical nephrectomy is the mainstay of treatment in patients with localised disease.

METHODS: We conducted an analysis of data from the cancer registry of Eastern Switzerland on patients with surgery for RCC from 2009 to 2018, focusing on a comparison of surgical technique and outcome in tertiary and non-tertiary hospitals.

RESULTS: 492 nephrectomies were performed. Out of 441 curative procedures, 226 were radical and 195 partial nephrectomies (20 unknown). At the tertiary hospital, statistically significantly more partial nephrectomies were performed in non-metastatic patients than at non-tertiary hospitals. We demonstrate a trend towards better disease-free survival after partial compared with radical nephrectomy. The 5-year overall survival for patients diagnosed between 2009 and 2013 was 85%, 83%, and 70% in stage I, II, and III, respectively, compared with 96%, 78%, and 72% for patients diagnosed between 2014 and 2018.

CONCLUSION: RCC incidence in Switzerland has been stable during the past decade in contrast to other European countries, and no stage migration occurred. We demonstrated that patients with localised renal cancer at our tertiary centre were more likely to be treated with renal preserving surgery compared with non-tertiary hospitals. This analysis underlines the importance of local cancer registries in the comparison of treatment and outcome over time.

References

  1. Bundesamt für Statistik NK. Krebs, Neuerkrankungen und Sterbefälle: Anzahl, Raten, Medianalter und Risiko pro Krebslokalisation. 12 November 2020.
  2. Li P, Znaor A, Holcatova I, Fabianova E, Mates D, Wozniak MB, et al. Regional geographic variations in kidney cancer incidence rates in European countries. Eur Urol. 2015 Jun;67(6):1134–41. https://doi.org/10.1016/j.eururo.2014.11.001
  3. Scelo G, Larose TL. Epidemiology and Risk Factors for Kidney Cancer. J Clin Oncol. 2018 Oct;36(Oct):JCO2018791905. https://doi.org/10.1200/JCO.2018.79.1905
  4. Ferlay J, Colombet M, Soerjomataram I, et al. Cancer incidence and mortality patterns in Europe: Estimates for 40 countries and 25 major cancers in 2018. Eur J Cancer. 11 2018;103:356-387. doi:https://doi.org/10.1016/j.ejca.2018.07.005
  5. Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2017. CA Cancer J Clin. 2017 Jan;67(1):7–30. https://doi.org/10.3322/caac.21387
  6. Ljungberg B, Hanbury DC, Kuczyk MA, Merseburger AS, Mulders PF, Patard JJ, et al.; European Association of Urology Guideline Group for renal cell carcinoma. Renal cell carcinoma guideline. Eur Urol. 2007 Jun;51(6):1502–10. https://doi.org/10.1016/j.eururo.2007.03.035
  7. MacLennan S, Imamura M, Lapitan MC, Omar MI, Lam TB, Hilvano-Cabungcal AM, et al.; UCAN Systematic Review Reference Group; EAU Renal Cancer Guideline Panel. Systematic review of oncological outcomes following surgical management of localised renal cancer. Eur Urol. 2012 May;61(5):972–93. https://doi.org/10.1016/j.eururo.2012.02.039
  8. Janzen NK, Kim HL, Figlin RA, Belldegrun AS. Surveillance after radical or partial nephrectomy for localized renal cell carcinoma and management of recurrent disease. Urol Clin North Am. 2003 Nov;30(4):843–52. https://doi.org/10.1016/S0094-0143(03)00056-9
  9. Janowitz T, Welsh SJ, Zaki K, Mulders P, Eisen T. Adjuvant therapy in renal cell carcinoma-past, present, and future. Semin Oncol. 2013 Aug;40(4):482–91. https://doi.org/10.1053/j.seminoncol.2013.05.004
  10. Haas NB, Manola J, Uzzo RG, Flaherty KT, Wood CG, Kane C, et al. Adjuvant sunitinib or sorafenib for high-risk, non-metastatic renal-cell carcinoma (ECOG-ACRIN E2805): a double-blind, placebo-controlled, randomised, phase 3 trial. Lancet. 2016 May;387(10032):2008–16. https://doi.org/10.1016/S0140-6736(16)00559-6
  11. Ravaud A, Motzer RJ, Pandha HS, et al. Adjuvant Sunitinib in High-Risk Renal-Cell Carcinoma after Nephrectomy. N Engl J Med. 12 2016;375(23):2246-2254. doi:https://doi.org/10.1056/NEJMoa1611406
  12. Motzer RJ, Haas NB, Donskov F, Gross-Goupil M, Varlamov S, Kopyltsov E, et al.; PROTECT investigators. Randomized Phase III Trial of Adjuvant Pazopanib Versus Placebo After Nephrectomy in Patients With Localized or Locally Advanced Renal Cell Carcinoma. J Clin Oncol. 2017 Dec;35(35):3916–23. https://doi.org/10.1200/JCO.2017.73.5324
  13. A Study Comparing Nivolumab, Nivolumab in Combination With Ipilimumab and Placebo in Participants With Localized Kidney Cancer Who Underwent Surgery to Remove Part of a Kidney (CheckMate 914). https://clinicaltrials.gov/ct2/show/NCT03138512?cond=NCT03138512&draw=2&rank=1
  14. Mickisch GH, Garin A, van Poppel H, de Prijck L, Sylvester R ; European Organisation for Research and Treatment of Cancer (EORTC) Genitourinary Group. Radical nephrectomy plus interferon-alfa-based immunotherapy compared with interferon alfa alone in metastatic renal-cell carcinoma: a randomised trial. Lancet. 2001 Sep;358(9286):966–70. https://doi.org/10.1016/S0140-6736(01)06103-7
  15. Flanigan RC, Salmon SE, Blumenstein BA, Bearman SI, Roy V, McGrath PC, et al. Nephrectomy followed by interferon alfa-2b compared with interferon alfa-2b alone for metastatic renal-cell cancer. N Engl J Med. 2001 Dec;345(23):1655–9. https://doi.org/10.1056/NEJMoa003013
  16. Méjean A, Ravaud A, Thezenas S, et al. Sunitinib Alone or after Nephrectomy in Metastatic Renal-Cell Carcinoma. N Engl J Med. 08 2018;379(5):417-427. doi:https://doi.org/10.1056/NEJMoa1803675
  17. Ljungberg B, Albiges L, Abu-Ghanem Y, et al. European Association of Urology Guidelines on Renal Cell Carcinoma: The 2019 Update. Eur Urol. 05 2019;75(5):799-810. doi:https://doi.org/10.1016/j.eururo.2019.02.011
  18. Escudier B, Porta C, Schmidinger M, et al. Renal cell carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up†. Ann Oncol. 05 01 2019;30(5):706-720. doi:https://doi.org/10.1093/annonc/mdz056
  19. Cancer Registry Of Eastern Switzerland Krebsregister-ost.ch
  20. Organization WH. International Classification of Diseases for Oncology – Third Edition. 2000.
  21. James D. Brierley (Editor) MKGE, Christian Wittekind (Editor). TNM Classification of Malignant Tumours, 8th Edition. 2016.
  22. https://www.stata.com
  23. Waterhouse JA, Correa P, Powell J. Cancer incidence in five continents. Lyon: IARC; 1976.
  24. Dickman PW, Coviello E. Estimating and Modeling Relative Survival. Stata J. 2015;15(1):186–215. https://doi.org/10.1177/1536867x1501500112 https://doi.org/10.1177/1536867X1501500112
  25. Padala SA, Barsouk A, Thandra KC, Saginala K, Mohammed A, Vakiti A, et al. Epidemiology of Renal Cell Carcinoma. World J Oncol. 2020 Jun;11(3):79–87. https://doi.org/10.14740/wjon1279
  26. Akhtar M, Al-Bozom IA, Al Hussain T. Papillary Renal Cell Carcinoma (PRCC): an Update. Adv Anat Pathol. 2019 Mar;26(2):124–32. https://doi.org/10.1097/PAP.0000000000000220
  27. Patel HD, Gupta M, Joice GA, et al. Clinical Stage Migration and Survival for Renal Cell Carcinoma in the United States. Eur Urol Oncol. 07 2019;2(4):343-348. doi:https://doi.org/10.1016/j.euo.2018.08.023
  28. Capitanio U, Terrone C, Antonelli A, Minervini A, Volpe A, Furlan M, et al. Nephron-sparing techniques independently decrease the risk of cardiovascular events relative to radical nephrectomy in patients with a T1a-T1b renal mass and normal preoperative renal function. Eur Urol. 2015 Apr;67(4):683–9. https://doi.org/10.1016/j.eururo.2014.09.027
  29. Miller DC, Schonlau M, Litwin MS, Lai J, Saigal CS ; Urologic Diseases in America Project. Renal and cardiovascular morbidity after partial or radical nephrectomy. Cancer. 2008 Feb;112(3):511–20. https://doi.org/10.1002/cncr.23218

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