OncologyThermal Ablation vs Surgery for Localized Kidney Cancer: a Surveillance, Epidemiology, and End Results (SEER) Database Analysis
Section snippets
Data
Our patient sample was obtained from the most recent Surveillance, Epidemiology and End Results (SEER) data comprised of 17 regional tumor registries established by the National Cancer Institute, which was released in May 2010. SEER is an authoritative source of information on population-based cancer characteristics and represents approximately one quarter of the US population.16 The SEER registry collects information on cancer incidence and survival in the United States as well as information
Baseline Characteristics
Of 15,145 patients who underwent a procedure for a renal tumor that was ≤7 cm between 2004 and 2007, 578 underwent TA (RFA or CA), 4402 underwent PN, and 10,165 underwent RN. Table 1 illustrates the characteristics of the 578 patients who underwent TA, as compared to patients who underwent PN or RN during the same time period. On unadjusted analyses, there were statistically significant differences in term of age, year of diagnosis, marital status, tumor size (using the 4-cm cutoff or as a
Comment
To our knowledge, our study is the first population-based study to evaluate usage trends and practice patterns for ablative therapies for RCC in the United States. Our paper has several important findings worth discussing:
First, although the use of TA and PN are both increasing, only one third of patients with stage I RCC actually underwent either TA or PN (nephron-sparing procedures). Despite the reported oncologic equivalence and benefits of nephron-sparing procedures, two thirds of patients
Acknowledgments
This study used the linked SEER-Medicare database. The interpretation and reporting of these data are the sole responsibility of the authors. The authors acknowledge the efforts of the Applied Research Program, NCI; the Office of Research, Development and Information, CMS; Information Management Services (IMS), Inc.; and the Surveillance, Epidemiology and End Results (SEER) Program tumor registries in the creation of the SEER-Medicare database.
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Funding Support: This work was supported by the Trust Family Research Fund for Kidney Cancer presented to Toni K. Choueiri.