EURURO Vol. 72 No. 2

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Table 3 – Univariable associations of clinicopathologic features with the development of distant metastases, CSM, and ACM.
Feature Distant metastases Cancer-specific mortality All-cause mortality
HR (95% CI) p value HR (95% CI) p value HR (95% CI) p value
Year of surgery
1980–1991 1.0 (reference) 1.0 (reference) 1.0 (reference)
1992–2004 0.72 (0.45–1.16) 0.2 0.91 (0.57–1.47) 0.7 0.88 (0.57–1.38) 0.6
2005–2010 0.93 (0.57–1.53) 0.8 0.81 (0.48–1.37) 0.4 0.85 (0.52–1.38) 0.5
Age at surgery 0.95 (0.82–1.10) [2_TD$DIFF] 0.5 1.10 (0.94–1.29) 0.3 1.17 (1.01–1.36) 0.04
Male 1.00 (0.67–1.51) 0.9 0.87 (0.58–1.32) 0.5 0.89 (0.61–1.31) 0.6
Symptoms 2.16 (1.00–4.66) 0.050 2.10 (0.92–4.79) 0.08 2.02 (0.94–4.35) 0.07
Constitutional symptoms 1.67 (1.14–2.44) 0.009 1.71 (1.15–2.55) 0.009 1.66 (1.15–2.40) 0.007
Smoking history
Never 1.0 (reference) 1.0 (reference) 1.0 (reference)
Current 1.46 (0.92–2.34) 0.1 1.09 (0.66–1.79) 0.7 1.02 (0.64–1.63) 0.9
Former 1.16 (0.74–1.82) 0.5 1.28 (0.80–2.04) 0.3 1.24 (0.81–1.90) 0.3
ECOG PS 1 1.52 (0.96–2.40) 0.08 2.56 (1.60–4.10) < 0.001 2.42 (1.57–3.77) <0.001
Charlson comorbidity index 1.07 (0.94–1.23) 0.3 1.03 (0.90–1.17) 0.7 1.02 (0.90–1.16) 0.8
Body mass index 1.03 (0.99–1.06) 0.2 1.00 (0.97–1.04) 0.9 1.00 (0.96–1.03) 0.8
Body mass index 30 kg/m2 1.09 (0.73–1.62) 0.7 0.91 (0.60–1.39) 0.7 0.87 (0.59–1.29) 0.5
Radiographic evidence
Lymphadenopathy 1.34 (0.92–1.96) 0.1 1.10 (0.74–1.64) 0.6 1.10 (0.76–1.59) 0.6
Renal vein involvement 1.70 (1.15–2.52) 0.008 1.56 (1.04–2.32) 0.03 1.47 (1.01–2.14) 0.04
IVC involvement 2.03 (1.32–3.13) 0.001 1.61 (1.04–2.48) 0.03 1.43 (0.94–2.17) 0.09
Type of surgery
Open (radical or partial) 1.0 (reference) 1.0 (reference) 1.0 (reference)
Laparoscopic radical 1.25 (0.51–3.08) 0.6 0.99 (0.31–3.13) 0.9 0.77 (0.28–2.08) 0.6
Tumor size 1.02 (0.97–1.07) 0.5 1.01 (0.96–1.06) 0.8 1.01 (0.96–1.05) 0.8
RCC histologic subtype
All others 1.0 (reference) 1.0 (reference) 1.0 (reference)
Clear cell 2.16 (1.20–3.89) 0.01 1.55 (0.84–2.85) 0.2 1.37 (0.79–2.37) 0.3
Collecting duct or NOS 4.92 (2.18–11.14) <0.001 3.44 (1.51–7.84) 0.003 3.21 (1.49–6.89) 0.003
2010 pT classification
pT1–2 1.0 (reference) 1.0 (reference) 1.0 (reference)
pT3–4 1.41 (0.89–2.24) 0.1 1.51 (0.91–2.49) 0.1 1.31 (0.83–2.05) 0.3
2010 pT classification
pT1–3 1.0 (reference) 1.0 (reference) 1.0 (reference)
pT4 2.51 (1.29–4.90) 0.007 1.62 (0.82–3.21) 0.2 1.42 (0.73–2.74) 0.3
Grade
2–3 1.0 (reference) 1.0 (reference) 1.0 (reference)
4 1.56 (1.06–2.30) 0.02 1.78 (1.20–2.65) 0.005 1.70 (1.17–2.47) 0.006
Coagulative tumor necrosis 2.08 (1.23–3.52) 0.006 2.40 (1.35–4.27) 0.003 2.51 (1.48–4.25) <0.001
Sarcomatoid differentiation 1.46 (0.93–2.32) 0.1 2.50 (1.59–3.92) < 0.001 2.45 (1.60–3.74) <0.001
Number of LNs removed 1.00 (0.98–1.02 [4_TD$DIFF][3_TD$DIFF] 0.9 0.99 (0.97–1.01 [4_TD$DIFF] 0.3 0.99 (0.97–1.01 [4_TD$DIFF] 0.5
Number of LNs [3_TD$DIFF]removed 13 1.02 (0.66–1.59) 0.9 0.84 (0.53–1.35) 0.5 0.86 (0.56–1.34) 0.5
Number of positive LNs 1.01 (0.95–1.07) 0.8 1.02 (0.97–1.08) 0.5 1.03 (0.97–1.08) 0.3
Number of positive LNs 2 1.09 (0.73–1.64) 0.7 1.19 (0.78–1.81) 0.4 1.19 (0.81–1.75) 0.4
HR = hazard ratio; CI = confidence interval; ECOG PS = Eastern Cooperative Oncology Group performance status; IVC = inferior vena cava; RCC = renal cell
carcinoma; NOS = not otherwise specified; LNs = lymph nodes.
a HR represents a 10-unit increase.
b HR ratio represents a 1-unit increase.
Table 4 – Multivariable associations of clinicopathologic features with the development of distant metastases, cancer-specific mortality, and
all-cause mortality
Feature Distant metastases Cancer-specific mortality All-cause mortality
HR (95% CI) p value HR (95% CI) p value HR (95% CI) p value
Symptoms at presentation 2.40 (1.10-5.21) 0.03 – – – –
IVC tumor thrombus 1.99 (1.27-3.12) 0.003 – – – –
RCC histologic subtype – – – –
All others 1.0 (reference)
Clear cell 2.21 (1.21-4.04) 0.010
Collecting duct or NOS 4.28 (1.87-9.80) <0.001
pT4 stage (vs pT1–3) 2.64 (1.34-5.21) 0.005 – – – –
Coagulative tumor necrosis 2.51 (1.46-4.32) <0.001 2.24 (1.22-4.10) 0.009 2.50 (1.44-4.33) 0.001
Sarcomatoid differentiation – – 2.30 (1.45-3.62) <0.001 2.21 (1.43-3.40) <0.001
ECOG PS 1 – – 2.41 (1.50-3.87) <0.001 2.40 (1.55-3.71) <0.001
HR = hazard ratio; CI = confidence interval; ECOG PS = Eastern Cooperative Oncology Group performance status.
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