Renal cell carcinoma recurrence after nephrectomy for localized disease: Predicting survival from time of recurrence Journal Article
| Authors: | Eggener, S. E.; Yossepowitch, O.; Pettus, J. A.; Snyder, M. E.; Motzer, R. J.; Russo, P. |
| Article Title: | Renal cell carcinoma recurrence after nephrectomy for localized disease: Predicting survival from time of recurrence |
| Abstract: | Purpose: Prognostic factors for patients with metastatic renal cell carcinoma (RCC) are well established. However, the risk profile is unknown for patients with recurrent RCC after a nephrectomy for localized disease. Patients and Methods: From January 1989 to July 2005, we identified patients with localized RCC treated by nephrectomy who subsequently developed recurrent disease. We applied a validated prognostic scoring system previously developed for patients with metastatic RCC. Each patient was given a total risk score of 0 to 5, with one point for each of five prognostic variables (recurrence < 12 months after nephrectomy, serum calcium > 10 mg/dL, hemoglobin < lower limit of normal, lactate dehydrogenase > 1.5x upper limit of normal, and Karnofsky performance status < 80%). Patients were categorized into low- (score = 0), intermediate- (score = 1 to 2), and high-risk subgroups (score = 3 to 5). Results: Our final cohort included 118 patients, with a median survival time of 21 months from the time of recurrence. Median follow-up time for survivors was 27 months. Overall survival was strongly associated with risk group category (P < .0001). Low-risk, intermediate-risk, and high-risk criteria were fulfilled in 34%, 50%, and 16% of patients, respectively. Median survival time for low-risk, intermediate-risk, and high-risk patients was 76, 25, and 6 months, respectively. Two-year overall survival rates for low-risk, intermediate-risk, and high-risk patients were 88% (95% CI, 77% to 99%), 51% (95% CI, 37% to 65%), and 11% (95% CI, 0% to 24%), respectively. Conclusion: At disease recurrence after nephrectomy for localized disease, a scoring system based on objective clinical and laboratory data provides meaningful risk stratification for both patient counseling and clinical trial entry. © 2006 by American Society of Clinical Oncology. |
| Keywords: | adult; cancer survival; controlled study; major clinical study; cancer recurrence; cancer risk; follow up; calcium; hemoglobin; kidney carcinoma; nephrectomy; high risk patient; survival time; karnofsky performance status; scoring system; lactate dehydrogenase |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 24 |
| Issue: | 19 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2006-07-01 |
| Start Page: | 3101 |
| End Page: | 3106 |
| Language: | English |
| DOI: | 10.1200/jco.2005.04.8280 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 49" - "Export Date: 4 June 2012" - "CODEN: JCOND" - "Source: Scopus" |
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