Burden of Metastatic Renal Cell Carcinoma in France From 2008 To 2013: Analysis of the French National Hospital Database.

• A retrospective analysis was performed using the French national hospital database (PMSI), an exhaustive hospital discharge database that covers all hospital stays in public and private hospitals in France. For each hospital stay, the PMSI provides a compilation of administrative data (i.e. age, gender, residence code) and medical data (i.e. diagnosis, medical procedures performed during hospital stays). Each hospital stay is then classified in a diagnosis related group (DRG) and can be linked to a patient using the unique patient identification number. • We extracted all hospital stays from 2007 to 2013 with the ICD-10 codes for both renal cell carcinoma (C64*) and metastasis (C77*, C78*,C79*). Among hospital stays for mRCC, we extracted incident cases identified by the absence of hospitalization for mRCC and the absence of metastasis in the previous year. Hospital stays for which the patient identification number was not adequately recorded as well as hospital stays that could not be classified into a DRG were excluded. Hospital stays for non incident cases and patients aged under 18 were also excluded. • Included patients were followed until death and data were censored on December 2013 for living patients. • Descriptive analysis were performed in terms of hospital stays and patients. • The cost of hospitalizations for mRCC was calculated from the perspective of the French national health insurance. For this purpose, the DRG tariffs for both public and private settings were used. Context & Objective • Kidney cancer accounts for approximately 3% of all cancers in France(1). In 2012, there were 11,573 new cases of kidney cancer and 3,957 deaths in France(2). • Renal cell carcinoma (RCC) accounts for 85% to 92% of kidney cancer cases (1,3–4). Approximately 25% to 30% of patients with RCC have metastasis at diagnosis and up to 50% of patients who undergo curative renal resection are likely to develop metastatic renal cell carcinoma (mRCC)(4).