The aim of this study was to describe the characteristics, perioperative and oncological outcomes of renal cell carcinoma (RCC) surgery in patients <40 years of age.
This is a retrospective study of prospectively collected data of 4101 patients who underwent treatment for RCC from 1990-2015 in 28 centers from 8 Latin American countries. We compared baseline characteristics as well as clinical, perioperative and oncological outcomes according to age groups (≤40 vs. > 40 years). Surgical complications were classified with the Clavien-Dindo score. We calculated overall survival, cancer specific survival and progression free survival using Kaplan-Meier method and log-rank test.
The median follow-up was 20 ± 42 months. There were 332 patients (8.1%) ≤40 years of age. On bivariate analysis, younger patients had a better worse performance status (ECOG 0-1 in 5.4% vs. 6.7% p< 0.01) and lower ASA score. Earlier clinical stages (CG) were more frequent in patients under 40 years of age (CG I-II in 82.9% vs 70.3%, p<0.01) as well as other histology types (non clear cell RCC). Additionally, Multifocality and a lower pT stage was also more commonly observed in younger patients. There were no differences in surgical time, surgical margins, and overall complication rates. The primary tumor treatment modality of choice more commonly performed was partial nephrectomy in patients under 40 years. There were no differences in cancer specific survival (p= 0.06) and progression free survival (p= 0.45) between study groups.
Latin American patients under 40 years of age are more commonly associated with an early clinical stage at presentation, smaller pT tumors and a non-clear cell histology. Perioperative and oncological outcomes are similar compared to their older counterparts.