Clinical characteristics and outcomes of patients with recurrence 5 years after nephrectomy for localized renal cell carcinoma Journal Article

  

Authors:	Adamy, A.; Chong, K. T. ; Chade, D.; Costaras, J.; Russo, G.; Kaag, M. G.; Bernstein, M.; Motzer, R. J.; Russo, P.
Article Title:	Clinical characteristics and outcomes of patients with recurrence 5 years after nephrectomy for localized renal cell carcinoma
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. © 2011 American Urological Association Education and Research, Inc.
Keywords:	adult; cancer survival; aged; major clinical study; overall survival; histopathology; cancer recurrence; cancer risk; cancer patient; cancer staging; outcome assessment; metastasis; tumor volume; recurrence; kidney carcinoma; nephrectomy; survival time; karnofsky performance status; kidney; partial nephrectomy; radical nephrectomy; carcinoma, renal cell; neoplasm metastasis; recurrent disease; predictor variable; log rank test
Journal Title:	Journal of Urology
Volume:	185
Issue:	2
ISSN:	0022-5347
Publisher:	Elsevier Science, Inc.
Date Published:	2011-02-01
Start Page:	433
End Page:	438
Language:	English
DOI:	10.1016/j.juro.2010.09.100
PROVIDER:	scopus
PUBMED:	21167521
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-78651334136&partnerID=40&md5=f868bb95dff761d566087198d1470b6c
Notes:	--- - "Export Date: 4 March 2011" - "CODEN: JOURA" - "Source: Scopus"

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