Influence of border-age on survival of sporadic renal cell carcinoma: young adults versus octogenarians

Purpose: To compare the effects of two border-age groups: young adults and octogenarians on survival of sporadic renal cell carcinoma (RCC).

Methods: We reviewed the records of 1619 patients that underwent radical or partial nephrectomy due to RCC between January 2004 and December 2018 in two high-volume centers. Patients were divided into two groups based on their age: ≤ 40 years old (group 1) and ≥ 80 years old (group 2). We analyzed the demographic, clinical and histological features of the groups and performed univariable and multivariable Cox regression analyses to evaluate predictors associated with survival.

Results: Median ages of patients were 35.5 years and 82 years in group 1 (n = 90) and group 2 (n = 55), respectively. Radical nephrectomy rate was statistically higher in group 2 (p = 0.004). Median follow-up was 72 (11-192) months in group 1 and 30 months (5-103) in group 2 (p < 0.001). The 5-year (90.2% vs. 80.2%) and 8-year (84.8% vs. 60.2%) overall survivals (OS) of the groups were statistically different (p < 0.001). Patients in group 1 demonstrated a 5 and 10-year cancer-specific survival (CSS) of 90.2% and 84.7%, whereas these rates were 82.4% and 54.9% for group 2 (p < 0.05). We found that higher hemoglobin drop (HR: 1.497), presence of sarcomatoid differentiation (HR: 4.307), high-stage disease (HR: 2.704), and metastasis detected in the follow-up (HR: 12.805) were independent risk factors that shortened OS (p < 0.05).

Conclusion: Sporadic RCC was associated with a more favorable CSS and OS in young adults compared to the octogenarians. Although two border-age groups had similar pathologies, they have different prognosis and survival rates.