Comparison of cancer specific outcomes following minimally invasive and open surgical resection of early stage kidney cancer from a national cancer registry Journal Article


Authors: Auffenberg, G. B.; Curry, M.; Gennarelli, R.; Blum, K. A.; Elkin, E.; Russo, P.
Article Title: Comparison of cancer specific outcomes following minimally invasive and open surgical resection of early stage kidney cancer from a national cancer registry
Abstract: Purpose: With anecdotal observations of atypical recurrences following minimally invasive surgery and alongside new concerns following cervical cancer surgery, there is a need to evaluate cancer specific outcomes for minimally invasive kidney cancer surgery using national data. We evaluated cancer specific outcomes following minimally invasive surgery vs open surgery for early stage kidney cancer. Materials and Methods: We performed a retrospective population based cohort study using data from the SEER (Surveillance, Epidemiology, and End Results) program linked with Medicare claims that included beneficiaries at least 66 years old diagnosed between 2004 and 2013 with early stage, nonurothelial kidney cancer who underwent surgical resection within a year of diagnosis. We compared overall survival, disease specific survival, rate of second kidney cancer surgery and rate of postoperative systemic cancer therapy based on whether surgery was minimally invasive surgery or an open resection. Multivariable regression was used to account for confounders. Results: A total of 5,150 patients were included in analysis and 3,062 (59.5%) underwent minimally invasive surgery. On multivariable analysis minimally invasive surgery was not associated with differences in overall survival (HR 0.94, 95% CI 0.84-1.06) or disease specific survival (HR 0.96, 95% CI 0.83-1.11). Patients treated with minimally invasive surgery were more likely to receive systemic cancer therapy (HR 1.31, 95% CI 1.09-1.59). No difference in the rate of second surgery associated with surgical approach was observed. Conclusions: Use of minimally invasive surgery for early stage kidney cancer was not associated with differences in overall or disease specific survival, or the rate of second kidney cancer surgery. Patients treated with minimally invasive surgery received more postoperative systemic therapy, which could represent a disparate cancer specific outcome associated with minimally invasive surgery.
Keywords: kidney neoplasms; outcome; oncologic outcomes; renal tumors; minimally invasive surgical procedures; open radical nephrectomy; assessment, health care
Journal Title: Journal of Urology
Volume: 203
Issue: 6
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 2020-06-01
Start Page: 1094
End Page: 1099; editorial comment 1100
Language: English
ACCESSION: WOS:000539218300064
DOI: 10.1097/ju.0000000000000741
PROVIDER: wos
PUBMED: 31913076
Notes: Article -- Source: Wos
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MSK Authors
  1. Paul Russo
    505 Russo
  2. Kyle Blum
    25 Blum
  3. Michael A Curry
    7 Curry