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• W2078086145 abstract "You have accessJournal of UrologyKidney Cancer: Localized1 Apr 20111088 PREDICTORS AND OUTCOMES OF LATE RECURRENCE FROM RENAL CELL CARCINOMA FOLLOWING SURGICAL RESECTION Simon Kim, Christopher Weight, Bradley Leibovich, R. Houston Thompson, Christine Lohse, and Stephen Boorjian Simon KimSimon Kim Rochester, MN More articles by this author , Christopher WeightChristopher Weight Rochester, MN More articles by this author , Bradley LeibovichBradley Leibovich Rochester, MN More articles by this author , R. Houston ThompsonR. Houston Thompson Rochester, MN More articles by this author , Christine LohseChristine Lohse Rochester, MN More articles by this author , and Stephen BoorjianStephen Boorjian Rochester, MN More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1126AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES While the initial natural history after surgical resection for localized renal cell carcinoma (RCC) has been well-characterized, patterns of late recurrence continue to be defined. Here, we evaluated the clinical characteristics and survival of patients who experienced disease recurrence > 5 years following surgery. METHODS We identified 1,454 patients who were treated with radical nephrectomy (RN; n=1,193) or nephron-sparing surgery (NSS; n=261) for unilateral, sporadic pT1-4, Nx/N0, M0 RCC between 1970–2000, and who had remained free of disease for a minimum of 5 years after surgery. Subsequent late recurrence (> 5 years from surgery) was recorded and classified as renal (ipsilateral/contralateral kidney) recurrence and distant (all other sites) metastases. The incidence of late recurrence and distant metastases were estimated using the Kaplan Meier method, and clinicopathological variables associated with late recurrence were analyzed using Cox proportional hazard regression models. RESULTS Median follow-up after surgery was 13.9 years (range 5.1–38.9). In total, 63 (4.3%) patients experienced a late renal recurrence at a median of 9.3 years (range 5.1–25.3), while 172 (11.8%) patients developed late distant metastases at a median of 9.6 years (range: 5.1–26.6) following RN or NSS. Estimated recurrence-free survival at 10 and 15 years following surgery was 97.3% and 95.2% for renal recurrence and 93.1% and 85.9% for distant metastases, respectively. On multivariable analysis (Table), increased tumor size was associated with a higher rate of late renal recurrence, while increased tumor size, clear cell or collecting duct histology, and >pT1a tumor stage were associated with late distant metastases. CONCLUSIONS Patients undergoing surgical resection for localized RCC remain at life-long risk of disease recurrence. After a 5-year postoperative disease-free interval, approximately 5% experience renal recurrence and 15% demonstrate distant metastasis, respectively, during the ensuing ten years. Continued investigation to identify potential site-specific predictors of late recurrence will be necessary to guide postoperative surveillance regimens. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e437-e438 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Simon Kim Rochester, MN More articles by this author Christopher Weight Rochester, MN More articles by this author Bradley Leibovich Rochester, MN More articles by this author R. Houston Thompson Rochester, MN More articles by this author Christine Lohse Rochester, MN More articles by this author Stephen Boorjian Rochester, MN More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2078086145 title "1088 PREDICTORS AND OUTCOMES OF LATE RECURRENCE FROM RENAL CELL CARCINOMA FOLLOWING SURGICAL RESECTION" @default.
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