Hypertension Is a Risk Factor for Worse Renal Cell Carcinoma Outcomes

Patients with hypertension have worse renal cell carcinoma (RCC) outcomes, investigators reported at the Society of Urologic Oncology’s 24th Annual Meeting in Washington, DC.

Among 4859 patients who underwent radical or partial nephrectomy for RCC in the INMARC database, 2018 had hypertension and 2841 did not. Rates of overall survival (72.2% vs 88.2%), cancer-specific survival (83.8% vs 94%), and recurrence-free survival (82.8% vs 93.1%) at 5 years were all significantly lower among patients with vs without hypertension.

In multivariable analyses, stage 4 disease and hypertension appeared among the strongest risk factors for poor outcomes, Cesare Saitta, MD, of the University of California, San Diego, reported on behalf of his team. The risk for all-cause mortality was significantly increased 86%, 44%, and 23% for patients with stage 4 RCC, hypertension, and tumor necrosis, respectively, and 36% for those who underwent radical nephrectomy. Higher Charlson comorbidity index, larger tumor size, and older age also were significantly associated with all-cause death.

The risk for cancer-specific mortality significantly increased 171%, 42%, 7%, and 4% in patients with stage 4 disease, hypertension, higher Charlson comorbidity index, and larger tumor size, respectively, Dr Saitta reported.

Recurrence risk significantly increased 225%, 36%, and 7% in patients with stage 4 disease, hypertension, and larger tumor size, respectively.

The authors of a systematic review and meta-analysis recently published in the International Journal of Cancer also identified hypertension, tumor stage, and tumor size as important risk factors for RCC recurrence and mortality, as well as several other variables.

“Hypertension is an independent risk factor for worsened oncologic and survival outcomes in patients undergoing surgical treatment for RCC,” Dr Saitta and his team concluded. Whether medical and lifestyle interventions to reduce hypertension can improve these outcomes needs to be studied.

References

Saitta C, Afari JA, Patil D, et al. Hypertension is associated with worsened oncological survival outcomes in patients undergoing nephrectomy for renal cell carcinoma: analysis of the IMARC registry. Presented at the Society of Urologic Oncology 24th annual meeting, November 28-December 1, 2023. Poster 93.

Majdoub M, Yanagisawa T, Quhal F, et al. Role of clinicopathological variables in predicting recurrence and survival outcomes after surgery for non-metastatic renal cell carcinoma: systematic review and meta-analysis. Int J Cancer. Published online November 27, 2023. doi:10.1002/ijc.34793

This article originally appeared on Renal and Urology News