Five‐Year Clinical Outcomes Following Nephrectomy for Renal Cell Carcinoma: Evidence From a Nationwide Japanese Surgical Registry
Ryuichi Mizuno, Kyoko Yamamoto, Hiroyuki Yamamoto, Shingo Hatakeyama, Shinichi Sakamoto, Takahiro Yasui, Takashi Kobayashi, Toshiyuki Kamoto, Eiji Kikuchi, Akihiro Ito, Haruki KumeABSTRACT
Objectives
To characterize mid‐term oncological outcomes after nephrectomy for renal cell carcinoma (RCC) in Japan using the National Clinical Database (NCD).
Methods
We retrospectively analyzed patients with RCC who underwent nephrectomy between April and December 2018 and had at least 5 years of follow‐up recorded in the NCD. Age, sex, nephrectomy type, operative approach, and pathological T category were evaluated. Disease‐free survival (DFS) and overall survival (OS) were estimated using the Kaplan–Meier method and compared with the log‐rank test.
Results
Of 16 786 patients registered at 759 institutions, 9065 with available 5‐year follow‐up were analyzed. Patients aged ≥ 75 years comprised 24.7% of the cohort. Radical and partial nephrectomy were performed in 55.0% and 45.0% of patients, respectively. Median DFS and OS were not reached. Older age and male sex were associated with shorter DFS and OS. Radical nephrectomy and open surgery were also associated with shorter survival. Both DFS and OS decreased significantly with advancing pathological stage, with earlier recurrence in pT3–4 disease.
Conclusions
This nationwide NCD‐based study provides descriptive mid‐term survival data for patients with RCC undergoing nephrectomy in Japan. Age, sex, nephrectomy type, operative approach, and pathological stage were associated with survival differences. These findings provide real‐world outcome data for patients with available long‐term follow‐up and a basis for future risk‐adjusted analyses.