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Peer-reviewedCC BY-NC 4.0Bju International

The effect of time to nephrectomy on cancer‐specific mortality in pathological T stage (pT)1b–2 renal cancer

  • Michele Nicolazzini1,2,3
  • Federico Polverino1,4
  • Leonardo Quarta1,5,6
  • Maximilian Filzmayer1,7
  • Michele Petix1,8,9
  • Calogero Catanzaro1,10
  • Nick Lee1
  • Jordan A. Goyal1
  • Nicola Longo4
  • Gennaro Musi5
  • Felix K. H. Chun7
  • Alberto Briganti8
6 more authors
  • Riccardo Schiavina10
  • Shahrokh F. Shariat11,12,13,14
  • Carlotta Palumbo2
  • Alessandro Volpe2
  • Fred Saad1
  • Pierre I. Karakiewicz1
14 affiliations
  1. 1Cancer Prognostics and Health Outcomes Unit, Division of Urology University of Montréal Health Center Montréal Québec Canada
  2. 2Division of Urology, Department of Translational Medicine Maggiore della Carità Hospital, University of Eastern Piedmont Novara Italy
  3. 3Division of Urology, Department of Oncology University of Turin Turin Italy
  4. 4Department of Neurosciences, Science of Reproduction and Odontostomatology University of Naples Federico II Naples Italy
  5. 5Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute IRCCS San Raffaele Scientific Institute Milan Italy
  6. 6Vita‐Salute San Raffaele University Milan Italy
  7. 7Department of Urology, University Hospital Goethe University Frankfurt Frankfurt am Main Germany
  8. 8Department of Urology, IEO European Institute of Oncology IRCCS Milan Italy
  9. 9Università degli Studi di Milano Milan Italy
  10. 10Division of Urology IRCCS Azienda Ospedaliero‐universitaria di Bologna Bologna Italy
  11. 11Department of Urology, Comprehensive Cancer Center Medical University of Vienna Vienna Austria
  12. 12Department of Urology Weill Cornell Medical College New York NY USA
  13. 13Department of Urology University of Texas Southwestern Medical Center Dallas TX USA
  14. 14Hourani Center for Applied Scientific Research Al‐Ahliyya Amman University Amman Jordan
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Abstract

Objective: To assess the impact of prolonged time to surgery on cancer‐specific mortality (CSM) in patients with pathological T stage (pT)1b–2 N0M0 renal cell carcinoma (RCC) treated with nephrectomy (either partial [PN] or radical [RN]). Within the Surveillance, Epidemiology and End Results (SEER) database (2004–2021), we tested the effect of time to surgery >3 vs ≤3 months on CSM in patients with pT1b‐2N0M0 RCC.

Patients and Methods: Propensity score matching (PSM) and multivariable competing risks regression (CRR) were performed. Subgroup analyses stratified patients according to time to surgery interval (≤1 vs 1–3 months, ≤3 vs 3–6 months, ≤3 vs >6 months), histotype, and grade.

Results: Of 16 322 patients with pT1b–2 RCC treated with nephrectomy, time to surgery >3 months was recorded in 3023 (18%) patients. These patients were older (median age 64 vs 62 years) and harboured a smaller proportion of pT2 patients (19% vs 30%). After one‐to‐one PSM, 3023 (100%) patients with a time to surgery >3 months exhibited a 60‐month CSM of 7.6% vs 5.9% in 3023 (23%) patients with a time to surgery ≤3 months. In CRR time to surgery >3 months independently predicted 1.3‐fold higher CSM (P = 0.02). Subgroup analyses revealed a dose–response effect, with a CSM increase in 1.3‐fold fashion when time to surgery was 3–6 months vs 1.6‐fold fashion when time to surgery was >6 months. The detrimental effect of time to surgery>3 months was consistent across all grades but was not evidenced among patients with a non‐clear cell RCC.

Conclusion: In patients with pT1b‐2N0M0 treated with either PN or RN, prolonged time from diagnosis to surgery was associated with higher CSM. This association was not observed among patients with non‐clear cell RCC.

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Cite

BibTeXRIS
BibTeX
@article{nicolazzini2026effect,
  title = {{The effect of time to nephrectomy on cancer‐specific mortality in pathological T stage (pT)1b–2 renal cancer}},
  author = {Michele Nicolazzini and Federico Polverino and Leonardo Quarta and Maximilian Filzmayer and Michele Petix and Calogero Catanzaro and Nick Lee and Jordan A. Goyal and Nicola Longo and Gennaro Musi and Felix K. H. Chun and Alberto Briganti and Riccardo Schiavina and Shahrokh F. Shariat and Carlotta Palumbo and Alessandro Volpe and Fred Saad and Pierre I. Karakiewicz},
  journal = {Bju International},
  year = {2026},
  month = sep,
  doi = {10.1111/bju.70468},
  url = {https://doi.org/10.1111/bju.70468},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - The effect of time to nephrectomy on cancer‐specific mortality in pathological T stage (pT)1b–2 renal cancer
AU  - Michele Nicolazzini
AU  - Federico Polverino
AU  - Leonardo Quarta
AU  - Maximilian Filzmayer
AU  - Michele Petix
AU  - Calogero Catanzaro
AU  - Nick Lee
AU  - Jordan A. Goyal
AU  - Nicola Longo
AU  - Gennaro Musi
AU  - Felix K. H. Chun
AU  - Alberto Briganti
AU  - Riccardo Schiavina
AU  - Shahrokh F. Shariat
AU  - Carlotta Palumbo
AU  - Alessandro Volpe
AU  - Fred Saad
AU  - Pierre I. Karakiewicz
PY  - 2026
DA  - 2026/09/29
JO  - Bju International
DO  - 10.1111/bju.70468
UR  - https://doi.org/10.1111/bju.70468
AB  - Objective: To assess the impact of prolonged time to surgery on cancer‐specific mortality (CSM) in patients with pathological T stage (pT)1b–2 N0M0 renal cell carcinoma (RCC) treated with nephrectomy (either partial [PN] or radical [RN]). Within the Surveillance, Epidemiology and End Results (SEER) database (2004–2021), we tested the effect of time to surgery >3 vs ≤3 months on CSM in patients with pT1b‐2N0M0 RCC.  Patients and Methods: Propensity score matching (PSM) and multivariable competing risks regression (CRR) were performed. Subgroup analyses stratified patients according to time to surgery interval (≤1 vs 1–3 months, ≤3 vs 3–6 months, ≤3 vs >6 months), histotype, and grade.  Results: Of 16 322 patients with pT1b–2 RCC treated with nephrectomy, time to surgery >3 months was recorded in 3023 (18%) patients. These patients were older (median age 64 vs 62 years) and harboured a smaller proportion of pT2 patients (19% vs 30%). After one‐to‐one PSM, 3023 (100%) patients with a time to surgery >3 months exhibited a 60‐month CSM of 7.6% vs 5.9% in 3023 (23%) patients with a time to surgery ≤3 months. In CRR time to surgery >3 months independently predicted 1.3‐fold higher CSM (P = 0.02). Subgroup analyses revealed a dose–response effect, with a CSM increase in 1.3‐fold fashion when time to surgery was 3–6 months vs 1.6‐fold fashion when time to surgery was >6 months. The detrimental effect of time to surgery>3 months was consistent across all grades but was not evidenced among patients with a non‐clear cell RCC.  Conclusion: In patients with pT1b‐2N0M0 treated with either PN or RN, prolonged time from diagnosis to surgery was associated with higher CSM. This association was not observed among patients with non‐clear cell RCC.
SN  - 1464-4096
SN  - 1464-410X
ER  -