Five-year survival after surgical treatment for XXXX : a population-based competing risk analysis.

@entity1 @entity5 @entity703
BACKGROUND: @entity703 's rising incidence is largely attributable to the increased detection of small renal masses. Although surgery rates have paralleled this incidence trend, mortality continues to rise, calling into question the necessity of surgery for all @entity1 with renal masses. Using a population-based cohort, a competing risk analysis was performed to estimate @entity1 survival after surgery for @entity703 , as a function of @entity1 age and @entity5 size at diagnosis. METHODS: With data from the Surveillance, Epidemiology, and End Results Program (1983-2002), a cohort was assembled of 26,618 @entity1 with surgically treated, @entity703 . @entity1 were sorted into 20 age- @entity5 size categories and the numbers of @entity1 that were alive, dead from @entity703 , and dead from other causes were tabulated. Poisson regression models were fitted to obtain estimates of @entity5 -specific and competing-cause mortality. RESULTS: Age-specific @entity703 mortality was stable across all size strata but varied inversely with @entity5 size. @entity1 with the @entity5 enjoyed the lowest @entity5 -specific mortality (5% for masses<or=4 cm). Competing-cause mortality rose with increasing @entity1 age. The estimated 5-year competing-cause mortality for elderly subjects (>or=70 years) was 28.2% (95% confidence interval [CI]: 25.9%-30.8%), irrespective of @entity5 size. CONCLUSIONS: Despite surgical therapy, competing-cause mortality for @entity1 with renal masses rises with increasing @entity1 age. After 5 years, one-third of elderly @entity1 (>or=70 years) will die from other causes, suggesting the need for prospective studies to evaluate the role of active surveillance as an initial therapeutic approach for some small renal masses.
