Table 3.
Risk predictors of all-cause mortality by the time-to-SPM and site of SPM.
| Survival function from the first primary RCC diagnosis | Survival function from the SPM diagnosis | |||||||
|---|---|---|---|---|---|---|---|---|
| Unadjusted sHR (95%CI) | P-value | Adjusted (s) sHR (95%CI) | P-value | Unadjusted sHR (95%CI) | P-value | Adjusted sHR (95%CI) | P-value | |
| Time to SPM *§ | ||||||||
| >120 months | 1 reference | 1 reference | 1 reference | 1 reference | ||||
| 6<time≤12 months | 5.74 (3.87-8.49) | <0.001 | 27.56 (18.27-41.56) | <0.001 | 0.60 (0.40-0.89) | 0.011 | 0.86 (0.57-1.29) | 0.470 |
| 12<time≤24 months | 5.32 (3.60-7.85) | <0.001 | 25.20 (16.77-37.86) | <0.001 | 0.65 (0.44-0.97) | 0.033 | 0.94 (0.63-1.41) | 0.767 |
| 24<time≤36 months | 4.89 (3.30-7.24) | <0.001 | 18.65 (12.39-28.06) | <0.001 | 0.72 (0.48-1.08) | 0.112 | 0.99 (0.66-1.49) | 0.962 |
| 36<time≤48 months | 3.54 (2.38-5.28) | <0.001 | 12.16 (8.04-18.38) | <0.001 | 0.65 (0.44-0.98) | 0.040 | 0.92 (0.61-1.39) | 0.696 |
| 48<time≤60 months | 3.48 (2.33-5.20) | <0.001 | 9.90 (6.55-14.96) | <0.001 | 0.79 (0.52-1.18) | 0.253 | 1.05 (0.69-1.59) | 0.821 |
| 60<time≤72 months | 2.96 (1.96-4.45) | <0.001 | 7.34 (4.82-11.16) | <0.001 | 0.82 (0.54-1.24) | 0.338 | 1.05 (0.69-1.60) | 0.820 |
| 72<time≤84 months | 2.66 (1.76-4.04) | <0.001 | 5.03 (3.28-7.70) | <0.001 | 0.94 (0.61-1.43) | 0.757 | 1.11 (0.73-1.71) | 0.625 |
| 84<time≤96 months | 2.30 (1.50-3.53) | <0.001 | 3.99 (2.59-6.17) | <0.001 | 0.97 (0.63-1.49) | 0.880 | 1.06 (0.69-1.65) | 0.784 |
| 96<time≤108 months | 1.78 (1.12-2.84) | 0.015 | 2.81 (1.75-4.52) | <0.001 | 0.97 (0.60-1.55) | 0.898 | 1.18 (0.73-1.90) | 0.493 |
| 108<time≤120 months | 1.34 (0.80-2.26) | 0.269 | 2.01 (1.18-3.40) | 0.010 | 0.85 (0.50-1.45) | 0.559 | 0.93 (0.54-1.60) | 0.786 |
| Types of SPM *# | ||||||||
| Ipsilateral kidney | 1 reference | 1 reference | 1 reference | 1 reference | ||||
| Contralateral kidney | 2.34 (1.23-4.45) | 0.009 | 1.43 (0.74-2.76) | 0.286 | 1.63 (0.86-3.10) | 0.133 | 1.53 (0.79-2.95) | 0.206 |
| Brain | 15.68 (7.97-30.85) | <0.001 | 26.36 (12.05-57.65) | <0.001 | 21.06 (10.68-41.52) | <0.001 | 31.40 (14.24-69.23) | <0.001 |
| Cecum/Small Intestine | 4.81 (2.40-9.63) | <0.001 | 1.56 (0.76-3.21) | 0.223 | 3.67 (1.83-7.36) | <0.001 | 1.95 (0.95-3.99) | 0.068 |
| Colon/Rectum | 5.07 (2.67-9.63) | <0.001 | 2.24 (1.16-4.31) | 0.016 | 3.84 (2.02-7.30) | <0.001 | 2.45 (1.27-4.72) | 0.008 |
| Esophagus/Stomach | 10.23 (5.30-19.74) | <0.001 | 3.46 (1.76-6.79) | <0.001 | 9.37 (4.86-18.07) | <0.001 | 3.28 (1.67-6.44) | 0.001 |
| Female Breast | 2.12 (1.10-4.07) | 0.024 | 1.51 (0.77-2.98) | 0.234 | 1.64 (0.85-3.16) | 0.136 | 1.54 (0.78-3.03) | 0.214 |
| Gallbladder/bile duct | 13.16 (6.53-26.53) | <0.001 | 4.95 (2.40-10.20) | <0.001 | 11.69 (5.80-23.55) | <0.001 | 6.12 (2.97-12.60) | <0.001 |
| Liver | 9.30 (4.82-17.95) | <0.001 | 5.18 (2.64-10.17) | <0.001 | 10.01 (5.19-19.32) | <0.001 | 5.94 (3.03-11.66) | <0.001 |
| Lung/Bronchus | 9.85 (5.26-18.44) | <0.001 | 3.03 (1.59-5.78) | 0.001 | 8.60 (4.59-16.09) | <0.001 | 3.03 (1.59-5.78) | 0.001 |
| Pancreas | 12.11 (6.35-23.09) | <0.001 | 4.46 (2.29-8.68) | <0.001 | 15.06 (7.89-28.72) | <0.001 | 5.85 (3.00-11.42) | <0.001 |
| Prostate | 1.74 (0.92-3.29) | 0.087 | 0.43 (0.22-0.83) | 0.011 | 1.21 (0.64-2.28) | 0.556 | 0.49 (0.26-0.95) | 0.035 |
| Thyroid | 1.20 (0.57-2.52) | 0.635 | 0.76 (0.36-1.61) | 0.468 | 0.80 (0.38-1.68) | 0.552 | 0.84 (0.40-1.80) | 0.658 |
| Urinary Bladder | 3.63 (1.90-6.94) | <0.001 | 3.65 (1.84-7.26) | <0.001 | 2.52 (1.32-4.82) | 0.005 | 3.91 (1.96-7.79) | <0.001 |
| Uteri/Ovary | 3.46 (1.73-6.91) | <0.001 | 2.03 (0.99-4.16) | 0.053 | 2.96 (1.48-5.92) | 0.002 | 2.15 (1.05-4.40) | 0.036 |
| Types of SPM ** | ||||||||
| All site of SPM (None-SPM as a reference) ¶ |
1.40 (1.33-1.46) | <0.001 | 1.26 (1.20-1.32) | <0.001 | – | – | – | – |
| All site of SPM (None-SPM as a reference) θ |
1.34 (1.28-1.42) | <0.001 | 1.23 (1.17-1.30) | <0.001 | – | – | – | – |
SPM, second primary malignancy; CI, confidence interval; sHR, Sub-distribution hazard ratio; AJCC, American Joint Committee on Cancer system; RCC, renal cell carcinoma.
* All SPM in solid malignancy (n= 5008) exclude acute/chronic leukemia/myeloma, melanoma of the skin, NHL/Hodgkin, miscellaneous.
§ Multivariate analysis with all other covariables (age of first primary RCC [for OS from first primary RCC diagnosis analysis] or the age of SPM [for OS from SPM diagnosis analysis], respectively], sex, race, marital status, population, region, family income, tumor grade, histological type of first primary RCC, tumor size of first primary RCC, tumor TNM stage of RCC and SPM, and treatment of RCC and SPM, and types of SPM).
# Multivariate analysis with all other covariables (age of first primary RCC [for OS from first primary RCC diagnosis analysis] or the age of SPM [for OS from SPM diagnosis analysis], respectively], sex, race, marital status, population, region, family income, tumor grade, histological type of first primary RCC, tumor size of first primary RCC, tumor TNM stage of RCC and SPM, and treatment of RCC and SPM, and time-to-SPM).
** Multivariate analysis with all other covariables (age of first primary RCC, sex, race, marital status, population, region, family income, tumor grade, histological type of first primary RCC, tumor TNM stage, and tumor size of first primary RCC) based the data of all cohort including the patient with none-SPM and SPM.
¶ Univariate and multivariate Cox proportional risk regression before propensity score matching.
θ Univariate and multivariate Cox proportional risk regression analysis after 1: 5 propensity score matching.