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Clinical Characteristics and Outcomes of Patients With Recurrence 5 Years After Nephrectomy for Localized Renal Cell Carcinoma

2010; Lippincott Williams & Wilkins; Volume: 185; Issue: 2 Linguagem: Inglês

10.1016/j.juro.2010.09.100

1527-3792

Ari Adamy, Kian Tai Chong, Daher C. Chade, James Costaras, G.I. Russo, Matthew Kaag, Melanie Bernstein, Robert J. Motzer, Paul Russo,

Renal and related cancers

No AccessJournal of UrologyAdult Urology1 Feb 2011Clinical Characteristics and Outcomes of Patients With Recurrence 5 Years After Nephrectomy for Localized Renal Cell Carcinoma Ari Adamy, Kian Tai Chong, Daher Chade, James Costaras, Grace Russo, Matthew G. Kaag, Melanie Bernstein, Robert J. Motzer, and Paul Russo Ari AdamyAri Adamy , Kian Tai ChongKian Tai Chong , Daher ChadeDaher Chade , James CostarasJames Costaras , Grace RussoGrace Russo , Matthew G. KaagMatthew G. Kaag , Melanie BernsteinMelanie Bernstein , Robert J. MotzerRobert J. Motzer , and Paul RussoPaul Russo View All Author Informationhttps://doi.org/10.1016/j.juro.2010.09.100AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We analyzed characteristics in patients with recurrent renal cell carcinoma 5 years or later after nephrectomy and determined predictors of survival after recurrence. Materials and Methods: From July 1989 to October 2008 at total of 2,368 nephrectomies were done for clinically localized, unilateral renal cell carcinoma at our institution. Of 256 patients with disease recurrence 44 had recurrence 5 years or more after nephrectomy. We compared clinicopathological characteristics in patients with disease recurrence before vs after 5 years. Survival from time of recurrence was assessed based on Memorial Sloan-Kettering Cancer Center risk score, symptoms at recurrence, metastasectomy, tumor diameter, and recurrence stage and site. Results: Patients with late recurrence tended to have fewer symptoms at presentation, smaller tumors (median 8.5 vs 7 cm) and less aggressive disease (pT1 in 18% vs 39%). Median overall survival was 6.1 years from time of recurrence. Five-year actuarial survival was 85% in 28 patients at favorable risk and 14% in 10 at intermediate risk (log rank p <0.001). The 5-year estimated overall survival rate was 72% in 31 patients with incidentally detected recurrence and 39% in 11 with symptoms at recurrence (log rank p = 0.01). Conclusions: Data suggest that patients with cancer recurrence 5 years after nephrectomy are at favorable risk and have long-term median survival. A favorable Memorial Sloan-Kettering Cancer Center risk score and absent symptoms related to metastasis are associated with longer survival in these patients. References 1 : Cancer statistics, 2009. CA Cancer J Clin2009; 59: 225. Google Scholar 2 : A postoperative prognostic nomogram for renal cell carcinoma. J Urol2001; 166: 63. Link, Google Scholar 3 : Comparison of predictive accuracy of four prognostic models for nonmetastatic renal cell carcinoma after nephrectomy: a multicenter European study. Cancer2005; 104: 1362. 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Google Scholar © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byLaguna M (2019) Re: Axitinib versus Placebo as an Adjuvant Treatment of Renal Cell Carcinoma: Results from the Phase III, Randomized ATLAS TrialJournal of Urology, VOL. 202, NO. 1, (27-28), Online publication date: 1-Jul-2019.Laguna M (2019) Re: Adjuvant Vascular Endothelial Growth Factor-Targeted Therapy in Renal Cell Carcinoma: A Systematic Review and Pooled AnalysisJournal of Urology, VOL. 201, NO. 6, (1050-1051), Online publication date: 1-Jun-2019.Laguna M (2014) Re: ClearCode34: A Prognostic Risk Predictor for Localized Clear Cell Renal Cell CarcinomaJournal of Urology, VOL. 193, NO. 1, (71-72), Online publication date: 1-Jan-2015.Donat S, Diaz M, Bishoff J, Coleman J, Dahm P, Derweesh I, Herrell S, Hilton S, Jonasch E, Lin D, Reuter V and Chang S (2013) Follow-up for Clinically Localized Renal Neoplasms: AUA GuidelineJournal of Urology, VOL. 190, NO. 2, (407-416), Online publication date: 1-Aug-2013. Volume 185Issue 2February 2011Page: 433-438 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordsrecurrenceneoplasm metastasiscarcinomarenal cellkidneynephrectomyMetricsAuthor Information Ari Adamy More articles by this author Kian Tai Chong More articles by this author Daher Chade More articles by this author James Costaras More articles by this author Grace Russo More articles by this author Matthew G. Kaag More articles by this author Melanie Bernstein More articles by this author Robert J. Motzer More articles by this author Paul Russo Financial interest and/or other relationship with Wilex. More articles by this author Expand All Advertisement PDF downloadLoading ...