Local and Regional Recurrences of Clinically Localized Renal Cell Carcinoma after Nephrectomy: A 15 Year Institutional Experience with Prognostic Features and Oncologic Outcomes - 11/08/21
Abstract |
Objective |
To evaluate outcomes for patients with local recurrence (LR) of clinically localized renal cell carcinoma (RCC) without concurrent systemic metastasis from our institution, an event that occurs rarely (1%-3%) after surgery. LR may be a harbinger of poor outcomes, and the best management of these patients is unclear.
Materials/Methods |
We retrospectively reviewed patients surgically treated for clinically localized RCC (cT1-2N0M0) with subsequent LR (in the partial or radical nephrectomy bed) and/or regional recurrence (RR; in the abdomen distant from the direct site of surgery) without concurrent metastasis from our institutional database (2004-2018). Comparative and survival analyses were performed.
Results |
Out of 3038 total patients, 1895 had clinically localized RCC, with 30 patients (1.6%) having isolated LR/RR. Median time to recurrence was 26.5 months (IQR:16-35). Of 26 patients treated with local therapy, 14 (53.8%) recurred over a median follow-up time of 29.5 months (IQR:12-45). The 1-year and 2-year secondary recurrence-free survival rates are 60.7% and 49.7%, respectively. Two or more sites of locoregional recurrence significantly predicted secondary recurrence/metastasis after local therapy for local recurrence (hazard ratio: 2.22, P= .04).
Conclusion |
Our results suggest local therapy is appropriate for select patients with LR/RR, with almost 50% of patients undergoing a second local therapy remaining alive with “local cure” and no secondary recurrence. The number of sites of recurrence can be used to better select patients that will benefit from local therapy or systemic/combination therapy. This work provides a framework onto which further studies regarding local therapy and locoregional recurrence of RCC can be performed.
Le texte complet de cet article est disponible en PDF.Keywords : Renal cell carcinoma, local recurrences, locoregional recurrences, surgery, survival, outcomes
Plan
Author Contributions: All authors contributed to study conception, design, assembly, analysis, manuscript writing, and the final approval of the manuscript. |
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Conflicts of Interests: The authors have no conflicts of interest relevant to this article to disclose. |
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Financial Disclosures: There is no external funding for this manuscript. The authors have no financial relationships relevant to this article to disclose. No honorarium, grant, or other form of payment was given to anyone to produce the manuscript. |
Vol 154
P. 201-207 - août 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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