Login to Access Video or Poster Abstract: MP69-11
Sources of Funding: None

Introduction

Multiple surveillance guidelines exist for kidney cancer following surgical intervention. Although these recommendations lack conformity, the majority do use stage as well as surgery type to stratify surveillance intensity. Due to guideline heterogeneity, it remains unclear what factors influence surveillance intensity in current practice. Our objective was to assess the patterns of surveillance intensity in kidney cancer after primary surgical intervention among patients ≥66 years.

Methods

Using SEER-Medicare, we identified patients diagnosed with non-metastatic kidney cancer who had undergone primary surgical intervention (n = 2433) from 2007 to 2011. Surveillance intensity was measured as the number of unique inpatient and outpatient claims made for kidney cancer (ICD-9 diagnosis code 189.0) starting 60 days after primary intervention. Using multivariable linear regression, we assessed the relationships between patient related factors and surveillance intensity (log-transformed). Parameters from the model were reported using risk ratios (RRs).

Results

Patients diagnosed in later years experienced more surveillance with an estimated 10% greater number of visits/12months occurring with each subsequent calendar year (RR 1.10 for every 1-year increase, 95% CI 1.07-1.13, p<0.001). As compared to pT1 stage, patients with pT2-4 disease experienced 108% more surveillance visits/12 months (RR 2.08, 95%CI 1.90-2.27, p<0.001). Both older age and living in a metro/urban area, as compared to a big metropolitan location, were associated with significantly fewer follow-up visits (10-year increase in age: RR 0.89, 95%CI 0.83-0.95, p<0.001; metro/urban: RR 0.86, 95%CI 0.79-0.93, p<0.001). Surgery type (radical, partial or ablation), gender, race and Charlson comorbidity score were not significantly associated with surveillance.

Conclusions

Similar to guidelines, surveillance intensity in current practice was found to correlate with disease stage. However, surgery type played less of a role. Other factors such as year of diagnosis, location and younger patient age were associated with more surveillance administered. Further analysis is warranted to understand the reasons for this variation in current surveillance practice and its impact on oncologic care.

Funding

None