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• W2979406912 abstract "No AccessJournal of UrologyAdult Urology1 Apr 2020Local Recurrence Following Resection of Intermediate-High Risk Nonmetastatic Renal Cell Carcinoma: An Anatomical Classification and Analysis of the ASSURE (ECOG-ACRIN E2805) Adjuvant Trial Ziho Lee, Opeyemi A. Jegede, Naomi B. Haas, Michael R. Pins, Edward M. Messing, Judith Manola, Christopher G. Wood, Christopher J. Kane, Michael A. S. Jewett, Keith T. Flaherty, Janice P. Dutcher, Robert S. DiPaola, and Robert G. Uzzo Ziho LeeZiho Lee Fox Chase Cancer Center-Temple Health System, Philadelphia, Pennsylvania More articles by this author , Opeyemi A. JegedeOpeyemi A. Jegede ECOG-ACRIN Biostatistics Center, Dana-Farber Cancer Institute, Boston, Massachusetts More articles by this author , Naomi B. HaasNaomi B. Haas University of Pennsylvania, Philadelphia, Pennsylvania More articles by this author , Michael R. PinsMichael R. Pins Advocate Lutheran General Hospital, Park Ridge, Illinois More articles by this author , Edward M. MessingEdward M. Messing University of Rochester, Rochester, New York More articles by this author , Judith ManolaJudith Manola ECOG-ACRIN Biostatistics Center, Dana-Farber Cancer Institute, Boston, Massachusetts More articles by this author , Christopher G. WoodChristopher G. Wood MD Anderson Cancer Center, Houston, Texas Financial interest and/or other relationship with Pfizer. More articles by this author , Christopher J. KaneChristopher J. Kane University of California-San Diego, La Jolla, California More articles by this author , Michael A. S. JewettMichael A. S. Jewett University of Toronto, Toronto, Ontario, Canada More articles by this author , Keith T. FlahertyKeith T. Flaherty Massachusetts General Hospital Cancer Center, Boston, Massachusetts Financial interest and/or other relationship with Clovis Oncology, Strata Oncology, Vivid Biosciences, Checkmate Pharmaceuticals, X4 Pharmaceuticals, Sanofi, Amgen, Asana, Adaptimmune, Fount, Aeglea, Stattuck Labs, Tolero, Apricity, Oncoceutics, Fog Pharma, Neon, Tvardi, xCures, Monopteros, Vibliome, Novartis, Genentech, BMS, Merck, Takeda, Verastem, Boston Biomedical, Pierre Fabre and Debiopharm. More articles by this author , Janice P. DutcherJanice P. Dutcher Cancer Research Foundation of New York, Chappaqua, New York More articles by this author , Robert S. DiPaolaRobert S. DiPaola University of Kentucky College of Medicine, Lexington, Kentucky More articles by this author , and Robert G. UzzoRobert G. Uzzo ‡Correspondence: Department of Urologic Oncology, Fox Chase Cancer Center-Temple Health System, 333 Cottman Ave., Philadelphia, Pennsylvania 19111 telephone: 215-728-3096; FAX: 215-214-4035; E-mail Address: [email protected] Fox Chase Cancer Center-Temple Health System, Philadelphia, Pennsylvania More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000588AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We describe what is to our knowledge a novel classification system for local recurrence after surgery of renal cell carcinoma. We assessed its prognostic implications using prospective, randomized controlled data. Materials and Methods: We queried the ASSURE (Sunitinib Malate or Sorafenib Tosylate in Treating Patients With Kidney Cancer That Was Removed By Surgery) (ECOG-ACRIN [Eastern Cooperative Oncology Group-American College of Radiology Imaging Network] E2805) trial data for patients with fully resected, intermediate-high risk, nonmetastatic renal cell carcinoma with local recurrence. We used certain definitions, including type I—single recurrence in a remnant kidney or ipsilateral renal fossa, type II—single recurrence in the ipsilateral vasculature, the ipsilateral adrenal gland or a lymph node, type III—single recurrence in other intra-abdominal soft tissues or organs and type IV—any combination of types I-III or multiple recurrences of a single type. Multivariable logistic regression and the log rank test were performed to identify clinicopathological predictors and compare survival, respectively. Results: Of the 1,943 patients 300 (15.4%) had local recurrence, which was type I, II, III and IV in 66 (22.0%), 97 (32.3%), 87 (29.0%) and 50 (16.7%), respectively. Surgical modality (minimally invasive vs open) and type of surgery (partial vs radical) did not predict any local recurrence. Five-year cancer specific survival and overall survival were worse in patients with type IV recurrence (each p <0.001). There was no difference in survival among patients with types I to III recurrence. Conclusions: In patients with intermediate-high risk nonmetastatic renal cell carcinoma local recurrence appears to be a function of biology more than of surgical modality or surgery type. The prognosis for solitary intra-abdominal local recurrences appear similar regardless of location (types I-III). Local recurrences involving multiple sites and/or subdivisions are associated with worse survival (type IV). References 1. : Predictors of oncological outcome after resection of locally recurrent renal cell carcinoma. J Urol 2009; 181: 2044. Link, Google Scholar 2. : Renal cell carcinoma local recurrences: impact of surgical treatment and concomitant metastasis on survival. BJU Int 2006; 97: 933. Google Scholar 3. : Local recurrence after curative surgical treatment of renal cell cancer: a study of 91 patients. Clin Genitourin Cancer 2016; 14: e379. Google Scholar 4. : Comparison of partial nephrectomy and percutaneous ablation for cT1 renal masses. Eur Urol 2015; 67: 252. Google Scholar 5. : Outcome of isolated renal cell carcinoma fossa recurrence after nephrectomy. J Urol 2000; 164: 322. Link, Google Scholar 6. : Local recurrence after radical nephrectomy for kidney cancer: management and prediction of outcomes. A multi-institutional study. J Surg Oncol 2014; 109: 126. 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Google Scholar The corresponding author certifies that, when applicable, a statement(s) has been included in the manuscript documenting institutional review board, ethics committee or ethical review board study approval; principles of Helsinki Declaration were followed in lieu of formal ethics committee approval; institutional animal care and use committee approval; all human subjects provided written informed consent with guarantees of confidentiality; IRB approved protocol number; animal approved project number. Supported by the NCI (National Cancer Institute) of the NIH (National Institutes of Health) under Award Nos. CA180820 and CA180794. The content is solely the responsibilities of the authors and does not necessarily represent the official views of the NIH, nor does mention of trade names, commercial products, or organizations imply endorsement by the United States government. No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. Editor’s Note: This article is the first of 5 published in this issue for which category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 843 and 844. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue 4April 2020Page: 684-689Supplementary Materials Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.Keywordsneoplasm recurrenceprognosislocalcarcinomarenal cellclassificationnephrectomyAcknowledgmentThis study was coordinated by the ECOG-ACRIN Cancer Research Group, Drs. Peter J. O'Dwyer and Mitchell D. Schnall, Group Co-Chairs.MetricsAuthor Information Ziho Lee Fox Chase Cancer Center-Temple Health System, Philadelphia, Pennsylvania More articles by this author Opeyemi A. Jegede ECOG-ACRIN Biostatistics Center, Dana-Farber Cancer Institute, Boston, Massachusetts More articles by this author Naomi B. Haas University of Pennsylvania, Philadelphia, Pennsylvania More articles by this author Michael R. Pins Advocate Lutheran General Hospital, Park Ridge, Illinois More articles by this author Edward M. Messing University of Rochester, Rochester, New York More articles by this author Judith Manola ECOG-ACRIN Biostatistics Center, Dana-Farber Cancer Institute, Boston, Massachusetts More articles by this author Christopher G. Wood MD Anderson Cancer Center, Houston, Texas Financial interest and/or other relationship with Pfizer. More articles by this author Christopher J. Kane University of California-San Diego, La Jolla, California More articles by this author Michael A. S. Jewett University of Toronto, Toronto, Ontario, Canada More articles by this author Keith T. Flaherty Massachusetts General Hospital Cancer Center, Boston, Massachusetts Financial interest and/or other relationship with Clovis Oncology, Strata Oncology, Vivid Biosciences, Checkmate Pharmaceuticals, X4 Pharmaceuticals, Sanofi, Amgen, Asana, Adaptimmune, Fount, Aeglea, Stattuck Labs, Tolero, Apricity, Oncoceutics, Fog Pharma, Neon, Tvardi, xCures, Monopteros, Vibliome, Novartis, Genentech, BMS, Merck, Takeda, Verastem, Boston Biomedical, Pierre Fabre and Debiopharm. More articles by this author Janice P. Dutcher Cancer Research Foundation of New York, Chappaqua, New York More articles by this author Robert S. DiPaola University of Kentucky College of Medicine, Lexington, Kentucky More articles by this author Robert G. Uzzo Fox Chase Cancer Center-Temple Health System, Philadelphia, Pennsylvania ‡Correspondence: Department of Urologic Oncology, Fox Chase Cancer Center-Temple Health System, 333 Cottman Ave., Philadelphia, Pennsylvania 19111 telephone: 215-728-3096; FAX: 215-214-4035; E-mail Address: [email protected] More articles by this author Expand All The corresponding author certifies that, when applicable, a statement(s) has been included in the manuscript documenting institutional review board, ethics committee or ethical review board study approval; principles of Helsinki Declaration were followed in lieu of formal ethics committee approval; institutional animal care and use committee approval; all human subjects provided written informed consent with guarantees of confidentiality; IRB approved protocol number; animal approved project number. Supported by the NCI (National Cancer Institute) of the NIH (National Institutes of Health) under Award Nos. CA180820 and CA180794. The content is solely the responsibilities of the authors and does not necessarily represent the official views of the NIH, nor does mention of trade names, commercial products, or organizations imply endorsement by the United States government. No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. Editor’s Note: This article is the first of 5 published in this issue for which category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 843 and 844. Advertisement PDF downloadLoading ..." @default.
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