Association of age, sex, and other risk factors with survival in patients with renal cell carcinoma

Abstract

Renal cell carcinoma is a complex cancer, with its incidence rising among elderly patients. It affects both males and females, but males are twice as likely to develop kidney cancer than females. This study aims to provide the relationship of gender and age factors to treatment outcomes in patients with RCC. We conducted a retrospective cohort study included RCC patients aged 18 years and above who diagnosed and treated from Jan 2012 to December 2021 and completed the follow-up until December 2024. Descriptive statistics were used to summarized demographic and clinical demographic characteristics. Survival outcome at 5 years were analyzed using the Kaplan–Meier method and log-rank test.  A Cox proportional hazards model and p-values were reported based on likelihood ratio test were used to determine factors associated with overall survival. A total of 689 RCC patients were identified, the majority were male (72.13%) The mean and Median age were 57.39 years (SD 13.71) and 59.02 years (IQR 18.49), respectively. Over the past 10 years, 310 patients (44.99%) had died. The 5-years and 10-year overall survival rates were 61.16% (95%CI: 57.33-64.76) and 48.98% (95%CI: 44.31-53.49), respectively. The 5-year survival rates were significantly higher in females (68.30%) than in males (58.43%) (p=0.008). Patients aged over 60 had a 1.71 times higher risk of death compared to those under 60 (95%CI: 0.91-3.23, p-value =0.098). Significantly by sex, with 5-years survival of 58.43% in male and 68.30 % in female (p-value =0.008). Patient with Clear cell tumor was significantly associated with higher survival compared to non-clear cell (p-value =0.048). Patients covered under the Universal coverage Scheme and Social Security Scheme had increased mortality risk of 1.50 (95%CI: 0.78-2.87) and 3.37 (95%CI: 0.67-19.93), respectively. Tumor staging and smoking were identified as risk of mortality. Patient who smoked had a 65% higher risk of death than non-smoker. In conclusions, sex, older patient, histology subtype, tumor grade and staging were identified as significant prognostic factor for survival in kidney cancer patients. The study of treatment accessibility, healthcare system factors, including in the advocacy for inclusion in the National List of Medicines can help improve the survival and quality of life of the patients.