Renal cancer (RC) diagnosis has shifted toward earlier stages globally. However, this phenomenon and its impact on outcomes have not been characterized in Mexico. We aimed to analyze temporal trends in RC stage at diagnosis and assess their impact on survival rates.
We retrospectively analyzed 807 patients surgically treated (1980-2024), categorized by diagnosis decade. Median follow-up was 29.0 months (range: 0.0-298.4) calculated using reverse Kaplan-Meier method. We developed the Stage Migration Index (SMI) using weighted averages of stage proportions to quantify migration magnitude. Survival was analyzed using Kaplan-Meier curves and multilevel analysis evaluated hierarchical effects of decade and stage on outcomes.
Stage I cases increased from 29.9% to 52.9%, while Stage III decreased from 31.9% to 13.4% (P < .001) and Stage IV from 10.6% to 6.7% (P = .317, nonsignificant). The SMI increased from 2.766 to 3.261, reflecting significant shift toward earlier stages (P < .001). Incidental detection increased from 44.7% (95% CI, 31.4%-58.8%) to 58.2% (95% CI, 49.7%-66.2%) (P < .001). Five-year survival improved from 85.7% (1980-1989) to 96.3% (2020-2024) (P < .001), though the 2020 to 2024 cohort had limited follow-up (median 1.4 months). Multilevel analysis revealed decade effects varied by stage, with greatest improvement for Stage IV patients (β = -0.542, P = .013). Among deceased patients, survival time increased from 5.2 to 50.2 months between 1980-1989 and 2010-2019 (P < .001). Limitations include retrospective single-center design, surgical cohort selection bias, and 12.5% missing survival data.
RC has undergone significant stage migration in Mexico over 4 decades. While this shift contributes to improved outcomes, our analysis demonstrates substantial survival gains across all stages, particularly in advanced disease, suggesting improvements in comprehensive RC management beyond earlier detection alone.
Clinical genitourinary cancer. 2025 Aug 20 [Epub ahead of print]
Jorge Augusto Alcacio-Mendoza, Horst Emanuel Lagos-Beitz, Petra Betsabé Carreño-Hinojosa, Yoztinn Bernal-Benitez, Guillermo H Martínez-Delgado, Ricardo A Castillejos-Molina, Francisco Rodriguez-Covarrubias
Department of Urology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, 14080, Mexico City, Mexico., Department of Urology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, 14080, Mexico City, Mexico. Electronic address: .