Journal article
The association of anxiety and depression with perioperative and oncologic outcomes among patients with clear cell renal cell carcinoma undergoing nephrectomy
Urologic oncology, Vol.38(2), pp.41.e19-41.e27
02/2020
DOI: 10.1016/j.urolonc.2019.10.017
PMID: 31761613
Abstract
•We reviewed 1,990 patients with radical or partial nephrectomy for localized kidney cancer.•Baseline anxiety and depression were identified using ICD-9 codes.•There was a significant association between anxiety or depression and inferior overall 30-day complications.•There was a nonsignificant association between anxiety of depression and worse overall survival.
Anxiety and depression have been associated with inferior overall survival for several malignancies, including metastatic renal cell carcinoma (RCC). However, there is minimal data evaluating this association for localized RCC. We evaluated the association of anxiety or depression with survival in patients with surgically treated localized clear cell RCC (ccRCC).
We reviewed our institutional nephrectomy registry of 1,990 adults who underwent radical or partial nephrectomy for unilateral, sporadic, nonmetastatic ccRCC between 1995 and 2011. Baseline anxiety and depression were identified using ICD-9 codes. Associations of anxiety or depression with 30-day complications and oncologic outcomes were evaluated using Cox proportional hazards models as well as adjustment for propensity score (PS) quintile and re-weighting by stabilized inverse probability weights.
A total of 197 (10%) patients were identified with a diagnosis of anxiety or depression. Median follow-up among survivors was 10.0 (IQR 7.3–13.6) years, during which time 864 patients died, including 363 from RCC. After PS adjustment, clinical and pathologic features were well balanced between groups. Patients with anxiety or depression had increased overall 30-day complications compared to those without (17% vs. 11%, P = 0.011). No significant differences were noted in time to local ipsilateral recurrence (P = 0.54), distant metastases (P = 0.96), or death from RCC (P = 0.42) between patients with vs. without anxiety or depression, while patients with anxiety or depression trended toward worse overall survival (hazard ratio 1.29, 95%CI 0.98–1.69, P = 0.065).
Neither anxiety nor depression were significantly associated with oncologic outcomes among patients who underwent surgery for localized ccRCC. The trend toward worse overall survival among patients with anxiety or depression warrants further investigation.
Details
- Title: Subtitle
- The association of anxiety and depression with perioperative and oncologic outcomes among patients with clear cell renal cell carcinoma undergoing nephrectomy
- Creators
- Vignesh T. Packiam - Mayo ClinicMark D Tyson II - Mayo Clinic in ArizonaMatvey Tsivian - Mayo Clinic in FloridaChristine M. Lohse - Mayo Clinic in FloridaStephen A. Boorjian - Mayo Clinic in ArizonaJohn C. Cheville - Mayo ClinicBrian A. Costello - Mayo Clinic in ArizonaBradley C. Leibovich - Mayo Clinic in ArizonaR. Houston Thompson - Mayo Clinic in Arizona
- Resource Type
- Journal article
- Publication Details
- Urologic oncology, Vol.38(2), pp.41.e19-41.e27
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.urolonc.2019.10.017
- PMID
- 31761613
- ISSN
- 1078-1439
- eISSN
- 1873-2496
- Language
- English
- Date published
- 02/2020
- Academic Unit
- Urology
- Record Identifier
- 9984319969802771
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