Introduction
Materials and methods
Data sources
Study population and study variables
Outcome assessments
Statistical analyses
Results
Variables | Localized | Regional | ||||
---|---|---|---|---|---|---|
Patients, n | Deaths, n | SMR (95% CI) | Patients, n | Deaths, n | SMR (95% CI) | |
Total | 11,3734 | 30,390 | 1.59# (1.57–1.6) | 29,602 | 14,437 | 3.36# (3.31–3.42) |
Age | ||||||
15–44 years | 13,137 | 1,041 | 3.24# (3.04–3.44) | 1,843 | 607 | 17.15# (15.82–18.57) |
45–54 years | 22,692 | 3,265 | 2.44# (2.35–2.52) | 4,646 | 1,739 | 8.07# (7.7–8.46) |
55–64 years | 31,595 | 6,713 | 1.97# (1.93–2.02) | 7,958 | 3,361 | 5.04# (4.87–5.21) |
65–74 years | 27,606 | 8,969 | 1.51# (1.48–1.54) | 8,112 | 4,222 | 3.17# (3.07–3.26) |
75 + years | 17,619 | 10,361 | 1.27# (1.25–1.3) | 6,246 | 4,451 | 2.18# (2.12–2.25) |
Sex | ||||||
Male | 69,116 | 18,873 | 1.56# (1.54–1.59) | 19,456 | 9,371 | 3.22# (3.15–3.28) |
Female | 44,618 | 11,517 | 1.62# (1.59–1.65) | 10,146 | 5,066 | 3.67# (3.57–3.77) |
Year of diagnosis | ||||||
2000–2007 | 39,932 | 18,042 | 1.58# (1.55–1.6) | 11,362 | 7,905 | 3.16# (3.09–3.23) |
2008–2012 | 34,484 | 8,521 | 1.57# (1.54–1.61) | 8,553 | 4,133 | 3.43# (3.33–3.54) |
2013–2017 | 39,318 | 3,827 | 1.67# (1.61–1.72) | 9,687 | 2,399 | 4.10# (3.94–4.27) |
Race | ||||||
White | 92,846 | 24,884 | 1.52# (1.51–1.54) | 25,262 | 12,322 | 3.20# (3.15–3.26) |
Black | 14,168 | 4,073 | 1.86# (1.81–1.92) | 2,400 | 1,274 | 4.61# (4.36–4.87) |
American Indian-Alaska Native | 891 | 247 | 4.19# (3.69–4.75) | 237 | 97 | 6.43# (5.21–7.84) |
Asian or Pacific Islander | 5,829 | 1,186 | 2.04# (1.93–2.16) | 1,703 | 744 | 4.84# (4.5–5.21) |
Grade | ||||||
Well differentiated | 11,586 | 2,302 | 1.39# (1.33–1.45) | 1,102 | 465 | 2.11# (1.92–2.31) |
Moderately differentiated | 42,645 | 7,706 | 1.33# (1.3–1.36) | 7,879 | 3,059 | 2.15# (2.07–2.22) |
Poorly differentiated | 18,250 | 4,089 | 1.62# (1.57–1.67) | 9,432 | 4,718 | 3.60# (3.5–3.71) |
Undifferentiated | 3,213 | 1,147 | 2.48# (2.34–2.62) | 5,275 | 3,164 | 5.68# (5.48–5.88) |
Pathological type | ||||||
Papillary | 13,202 | 2,996 | 1.38# (1.33–1.43) | 1,691 | 758 | 2.91# (2.71–3.13) |
Chromophores | 6,352 | 908 | 0.92# (0.86–0.98) | 1,005 | 254 | 1.67# (1.47–1.88) |
Clear cell | 58,472 | 12,549 | 1.47# (1.45–1.5) | 14,201 | 5,660 | 2.85# (2.78–2.93) |
Surgical treatment | ||||||
Partial nephrectomy | 33,344 | 3,535 | 1.02 (0.99–1.06) | 2,339 | 569 | 1.60# (1.47–1.74) |
Radical nephrectomy | 48,672 | 11,929 | 1.61# (1.58–1.64) | 24,595 | 11,902 | 3.27# (3.21–3.33) |
Local tumor destruction | 5,983 | 1,527 | 1.35# (1.29–1.42) | 128 | 78 | 3.44# (2.72–4.29) |
Surgery, NOS | 933 | 260 | 1.63# (1.44–1.84) | 410 | 215 | 3.22# (2.81–3.69) |
No | 7,084 | 3,933 | 3.11# (3.01–3.21) | 1,551 | 1,328 | 9.84# (9.31–10.38) |
Chemotherapy | ||||||
Yes | 1,732 | 453 | 5.29# (4.81–5.8) | 3,562 | 1,841 | 8.96# (8.55–9.38) |
No/unknown | 112,002 | 29,937 | 1.57# (1.55–1.59) | 26,040 | 12,596 | 3.08# (3.03–3.14) |
Causes of death for patients with localized disease
Causes of death | Total | Clear cell RCC | Non-clear cell RCC | ||||||
---|---|---|---|---|---|---|---|---|---|
Observed, n | Expected, n | SMR (95% CI) | Observed, n | Expected, n | SMR (95% CI) | Observed, n | Expected, n | SMR (95% CI) | |
All causes of death | 30,390 | 19,151.73 | 1.59# (1.57–1.6) | 12,549 | 8,512.19 | 1.47# (1.45–1.5) | 17,841 | 10,639.55 | 1.68# (1.65–1.7) |
All malignant cancers | 12,022 | 4,575.66 | 2.63# (2.58–2.67) | 5,118 | 2,095.27 | 2.44# (2.38–2.51) | 6,904 | 2,480.39 | 2.78# (2.72–2.85) |
Urinary system | 7,500 | 260.56 | 28.78# (28.14–29.44) | 3,267 | 117.66 | 27.77# (26.82–28.74) | 4,233 | 142.9 | 29.62# (28.74–30.53) |
Kidney and renal pelvis | 7,161 | 111.5 | 64.22# (62.74–65.73) | 3,220 | 51.54 | 62.48# (60.34–64.67) | 3,941 | 59.96 | 65.73# (63.69–67.81) |
Urinary bladder | 277 | 141.91 | 1.95# (1.73–2.2) | 44 | 62.87 | 0.70# (0.51–0.94) | 233 | 79.03 | 2.95# (2.58–3.35) |
Respiratory system | 1,315 | 1,318.67 | 1 (0.94–1.05) | 538 | 606.11 | 0.89# (0.81–0.97) | 777 | 712.56 | 1.09# (1.02–1.17) |
Lung and bronchus | 1,283 | 1,277.13 | 1 (0.95–1.06) | 529 | 587.53 | 0.90# (0.83–0.98) | 754 | 689.6 | 1.09# (1.02–1.17) |
Digestive system | 1,276 | 1,176.37 | 1.08# (1.03–1.15) | 566 | 540.52 | 1.05 (0.96–1.14) | 710 | 635.85 | 1.12# (1.04–1.2) |
Pancreas | 393 | 308.78 | 1.27# (1.15–1.41) | 174 | 143.53 | 1.21# (1.04–1.41) | 219 | 165.25 | 1.33# (1.16–1.51) |
Colon and rectum | 315 | 403.3 | 0.78# (0.7–0.87) | 140 | 181.26 | 0.77# (0.65–0.91) | 175 | 222.04 | 0.79# (0.68–0.91) |
Liver and intrahepatic bile duct | 275 | 183.41 | 1.50# (1.33–1.69) | 126 | 86.78 | 1.45# (1.21–1.73) | 149 | 96.63 | 1.54# (1.3–1.81) |
Male genital system | 183 | 324.19 | 0.56# (0.49–0.65) | 72 | 132.98 | 0.54# (0.42–0.68) | 111 | 191.22 | 0.58# (0.48–0.7) |
Prostate | 178 | 319.62 | 0.56#(0.48–0.65) | 71 | 130.87 | 0.54# (0.42–0.68) | 107 | 188.74 | 0.57# (0.46–0.69) |
Brain and other nervous system | 159 | 100.52 | 1.58#(1.35–1.85) | 68 | 49.1 | 1.38# (1.08–1.76) | 91 | 51.42 | 1.77# (1.42–2.17) |
Leukemia | 190 | 182.42 | 1.04 (0.9–1.2) | 72 | 82.78 | 0.87 (0.68–1.1) | 118 | 99.64 | 1.18 (0.98–1.42) |
Lymphoma | 148 | 173.82 | 0.85 (0.72–1) | 62 | 79.52 | 0.78# (0.6–1) | 86 | 94.3 | 0.91 (0.73–1.13) |
Non-tumor causes | |||||||||
Diseases of heart | 6,161 | 4,945.61 | 1.25# (1.21–1.28) | 2,547 | 2,140.78 | 1.19# (1.14–1.24) | 3,614 | 2,804.84 | 1.29# (1.25–1.33) |
COPD and allied cond | 1,185 | 1,194.07 | 0.99 (0.94–1.05) | 470 | 543.39 | 0.86# (0.79–0.95) | 715 | 650.67 | 1.10# (1.02–1.18) |
Cerebrovascular diseases | 1,183 | 1,058.31 | 1.12# (1.06–1.18) | 480 | 455.48 | 1.05 (0.96–1.15) | 703 | 602.83 | 1.17# (1.08–1.26) |
Nephritis, nephrotic syndrome and nephrosis | 1,166 | 387.89 | 3.01# (2.84–3.18) | 409 | 165.73 | 2.47# (2.23–2.72) | 757 | 222.16 | 3.41# (3.17–3.66) |
Diabetes mellitus | 1,137 | 595.36 | 1.91# (1.8–2.02) | 488 | 265.59 | 1.84# (1.68–2.01) | 649 | 329.77 | 1.97# (1.82–2.13) |
Accidents and adverse effects | 668 | 602.41 | 1.11# (1.03–1.2) | 293 | 282.38 | 1.04 (0.92–1.16) | 375 | 320.03 | 1.17# (1.06–1.3) |
Alzheimer’s | 611 | 701.64 | 0.87# (0.8–0.94) | 242 | 300.21 | 0.81# (0.71–0.91) | 369 | 401.43 | 0.92 (0.83–1.02) |
Pneumonia and influenza | 489 | 429.8 | 1.14# (1.04–1.24) | 197 | 184.8 | 1.07 (0.92–1.23) | 292 | 245 | 1.19# (1.06–1.34) |
Hypertension without heart disease | 482 | 223.68 | 2.15# (1.97–2.36) | 192 | 96.06 | 2.00# (1.73–2.3) | 290 | 127.62 | 2.27# (2.02–2.55) |
Septicemia | 406 | 285.54 | 1.42# (1.29–1.57) | 164 | 125.48 | 1.31# (1.11–1.52) | 242 | 160.05 | 1.51# (1.33–1.71) |
Chronic liver disease and cirrhosis | 293 | 220.44 | 1.33# (1.18–1.49) | 149 | 110.01 | 1.35# (1.15–1.59) | 144 | 110.44 | 1.30# (1.1–1.54) |
Suicide and self-inflicted injury | 151 | 153.78 | 0.98 (0.83–1.15) | 83 | 78.18 | 1.06 (0.85–1.32) | 68 | 75.61 | 0.9 (0.7–1.14) |
Causes of death for patients with regional disease
Causes of deaths | Total | Clear cell RCC | Non-clear cell RCC | ||||||
---|---|---|---|---|---|---|---|---|---|
Observed, n | Expected, n | SMR (95% CI) | Observed, n | Expected, n | SMR (95% CI) | Observed, n | Expected, n | SMR (95% CI) | |
All causes of death | 14,437 | 4,292.43 | 3.36# (3.31–3.42) | 5,660 | 1,983.35 | 2.85# (2.78–2.93) | 8,777 | 2,309.08 | 3.80# (3.72–3.88) |
All malignant cancers | 10,352 | 1,016.84 | 10.18# (9.99–10.38) | 3,918 | 487.27 | 8.04# (7.79–8.3) | 6,434 | 529.57 | 12.15# (11.85–12.45) |
Urinary system | 8,746 | 61.07 | 143.22# (140.24–146.26) | 3,423 | 29.15 | 117.44# (113.54–121.44) | 5,323 | 31.92 | 166.77# (162.32–171.31) |
Kidney and renal pelvis | 8,240 | 25.34 | 325.20# (318.21–332.3) | 3,410 | 12.36 | 275.95# (266.77–285.37) | 4,830 | 12.98 | 372.08# (361.66–382.72) |
Urinary bladder | 371 | 34.05 | 10.90# (9.81–12.06) | 10 | 15.99 | 0.63 (0.3–1.15) | 361 | 18.06 | 19.99# (17.98–22.16) |
Ureter | 57 | 0.8 | 71.17# (53.91–92.21) | 0 | 0.38 | 0 (0–9.7) | 57 | 0.42 | 135.53# (102.65–175.59) |
Respiratory system | 354 | 295.99 | 1.20# (1.07–1.33) | 145 | 142.81 | 1.02 (0.86–1.19) | 209 | 153.19 | 1.36# (1.19–1.56) |
Lung and bronchus | 346 | 286.72 | 1.21# (1.08–1.34) | 140 | 138.32 | 1.01 (0.85–1.19) | 206 | 148.41 | 1.39# (1.2–1.59) |
Digestive System | 311 | 259.38 | 1.20# (1.07–1.34) | 119 | 125.56 | 0.95 (0.79–1.13) | 192 | 133.83 | 1.43# (1.24–1.65) |
Pancreas | 106 | 67.4 | 1.57# (1.29–1.9) | 36 | 32.89 | 1.09 (0.77–1.52) | 70 | 34.51 | 2.03# (1.58–2.56) |
Colon and rectum | 87 | 89.3 | 0.97 (0.78–1.2) | 35 | 41.94 | 0.83 (0.58–1.16) | 52 | 47.36 | 1.1 (0.82–1.44) |
Liver and intrahepatic bile duct | 48 | 39.77 | 1.21 (0.89–1.6) | 23 | 20.15 | 1.14 (0.72–1.71) | 25 | 19.61 | 1.27 (0.82–1.88) |
Male genital system | 46 | 78.63 | 0.59# (0.43–0.78) | 18 | 35.37 | 0.51# (0.3–0.8) | 28 | 43.26 | 0.65# (0.43–0.94) |
Prostate | 43 | 77.58 | 0.55# (0.4–0.75) | 17 | 34.85 | 0.49# (0.28–0.78) | 26 | 42.73 | 0.61# (0.4–0.89) |
Soft tissue including heart | 50 | 6.27 | 7.98# (5.92–10.51) | 2 | 3.08 | 0.65 (0.08–2.35) | 48 | 3.19 | 15.05# (11.1–19.96) |
Brain and other nervous system | 44 | 22 | 2.00# (1.45–2.68) | 21 | 11.15 | 1.88# (1.17–2.88) | 23 | 10.86 | 2.12# (1.34–3.18) |
Leukemia | 35 | 42.31 | 0.83 (0.58–1.15) | 10 | 20.05 | 0.50# (0.24–0.92) | 25 | 22.25 | 1.12 (0.73–1.66) |
Lymphoma | 29 | 40.39 | 0.72 (0.48–1.03) | 13 | 19.15 | 0.68 (0.36–1.16) | 16 | 21.24 | 0.75 (0.43–1.22) |
Non-tumor causes | |||||||||
Diseases of heart | 1,424 | 1,128.76 | 1.26# (1.2–1.33) | 607 | 509.76 | 1.19# (1.1–1.29) | 817 | 619 | 1.32# (1.23–1.41) |
Cerebrovascular diseases | 289 | 238.34 | 1.21# (1.08–1.36) | 129 | 105.6 | 1.22# (1.02–1.45) | 160 | 132.73 | 1.21# (1.03–1.41) |
COPD and allied cond | 266 | 274.97 | 0.97 (0.85–1.09) | 104 | 129.15 | 0.81# (0.66–0.98) | 162 | 145.82 | 1.11 (0.95–1.3) |
Diabetes mellitus | 227 | 129.1 | 1.76# (1.54–2) | 112 | 60.84 | 1.84# (1.52–2.22) | 115 | 68.25 | 1.68# (1.39–2.02) |
Nephritis, nephrotic syndrome and nephrosis | 210 | 85.61 | 2.45# (2.13–2.81) | 90 | 38.64 | 2.33# (1.87–2.86) | 120 | 46.97 | 2.56# (2.12–3.06) |
Pneumonia and influenza | 138 | 100 | 1.38# (1.16–1.63) | 48 | 44.17 | 1.09 (0.8–1.44) | 90 | 55.82 | 1.61# (1.3–1.98) |
Alzheimer’s | 130 | 159.43 | 0.82# (0.68–0.97) | 60 | 69.31 | 0.87 (0.66–1.11) | 70 | 90.13 | 0.78# (0.61–0.98) |
Accidents and adverse effects | 130 | 128.41 | 1.01 (0.85–1.2) | 53 | 61.93 | 0.86 (0.64–1.12) | 77 | 66.49 | 1.16 (0.91–1.45) |
Septicemia | 108 | 61.91 | 1.74# (1.43–2.11) | 39 | 28.59 | 1.36 (0.97–1.86) | 69 | 33.32 | 2.07# (1.61–2.62) |
Hypertension without heart disease | 89 | 47.89 | 1.86# (1.49–2.29) | 37 | 21.55 | 1.72# (1.21–2.37) | 52 | 26.34 | 1.97# (1.47–2.59) |
Chronic liver disease and cirrhosis | 65 | 45.89 | 1.42# (1.09–1.81) | 35 | 24.07 | 1.45# (1.01–2.02) | 30 | 21.82 | 1.37 (0.93–1.96) |
Suicide and self-inflicted injury | 33 | 32.71 | 1.01 (0.69–1.42) | 15 | 17.1 | 0.88 (0.49–1.45) | 18 | 15.62 | 1.15 (0.68–1.82) |