Treatment and overall survival in renal cell carcinoma: a Swedish population-based study (2000-2008)

Br J Cancer. 2013 Apr 16;108(7):1541-9. doi: 10.1038/bjc.2013.119. Epub 2013 Mar 26.


Background: This retrospective register study assessed overall survival (OS) and influential factors on OS in Swedish renal cell carcinoma (RCC) patients.

Methods: Using three merged national health registers, Cox proportional-hazards analysis was conducted and, in three models, it was used to assess the impact of cytokine (interferon-α and tyrosine kinase inhibitor (TKI; sunitinib or sorafenib) treatment on OS in metastatic (m)RCC.

Results: From 2000 to 2008, 8009 patients were diagnosed with RCC and 2753 with mRCC (2002-2008). Median OS in RCC patients diagnosed from 2006 to 2008 compared with 2000-2005 was not reached vs 47.9 months (P<0.001), and in mRCC patients diagnosed from 2006 to 2008 compared with 2002-2005, was 12.4 vs 9.6 months, respectively (P=0.004). Factors associated with significantly improved OS in RCC were female gender, lower age, and previous nephrectomy, and, in mRCC female gender, previous nephrectomy, and any TKI prescription (Model 1: median-adjusted OS, 19.4 months (TKI patients) vs 9.7 months (non-TKI patients); hazard ratio, 0.621; P<0.001).

Conclusion: OS was improved in Swedish patients diagnosed with RCC and mRCC in the period 2006-2008 compared with 2000-2005 (RCC) and 2002-2005 (mRCC). Although multifactorial in origin, results suggest that increased nephrectomy rates and the use of TKIs contributed to the improvement seen in mRCC patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Carcinoma, Renal Cell / drug therapy*
  • Carcinoma, Renal Cell / mortality*
  • Female
  • Humans
  • Interferon-alpha / therapeutic use
  • Kidney Neoplasms / drug therapy*
  • Kidney Neoplasms / mortality*
  • Male
  • Proportional Hazards Models
  • Protein Kinase Inhibitors / therapeutic use
  • Registries
  • Retrospective Studies
  • Survival Analysis
  • Sweden / epidemiology
  • Treatment Outcome


  • Interferon-alpha
  • Protein Kinase Inhibitors