Local recurrence after curative surgical treatment of renal cell cancer

• Verfasst von: Du, YueJun [VerfasserIn]
• Verfasst von: Grüllich, Carsten [VerfasserIn]
• Verfasst von: Hadaschik, Boris [VerfasserIn]
• Verfasst von: Hatiboglu, Gencay [VerfasserIn]
• Verfasst von: Hohenfellner, Markus [VerfasserIn]
• Verfasst von: Pahernik, Sascha [VerfasserIn]
• Titel: Local recurrence after curative surgical treatment of renal cell cancer
• Titelzusatz: a study of 91 patients
• Verf.angabe: YueJun Du, Carsten Grüllich, Boris Hadaschik, Gencay Hatiboglu, Markus Hohenfellner, Sascha Pahernik
• E-Jahr: 2016
• Jahr: August 2016
• Umfang: 7 S.
• Fussnoten: Gesehen am 29.11.2018
• Titel Quelle: Enthalten in: Clinical genitourinary cancer
• Ort Quelle: Dallas, Tex. : CIG Media Group, 2005
• Jahr Quelle: 2016
• Band/Heft Quelle: 14(2016), 4, Seite e379-e385
• ISSN Quelle: 1938-0682
• DOI: doi:10.1016/j.clgc.2016.01.012
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Local recurrence
• Sach-SW: Prognosis
• Sach-SW: RCC
• Sach-SW: Risk factor
• Sach-SW: Surgery
• K10plus-PPN: 158462129X

Abstract

Background Local recurrence (LR) after curative therapy for renal cell cancer is a rare event, and surgery is still the primary treatment option. Patients and Methods This was a single-institution, single-arm retrospective study from a prospectively conducted database. A total of 91 patients with a median age of 63.0 years (interquartile range, 57.5-68.3), who had undergone LR resection after initial curative treatment of RCC were enrolled. The time to LR (TTLR) was defined as the interval from primary curative surgery to LR. Cancer-specific survival, overall survival, and progression-free survival were evaluated after LR resection. Statistical analyses of the clinical and pathologic variables were performed using Cox regression analysis and the Kaplan-Meier method. Results The median time to LR was 29.8 months (interquartile range, 10.8-64.3). On multivariate analysis, age > 65 years, T3/T4 stage, Fuhrman grade 3/4, major venous infiltration, and positive surgical margins were related to early LR after primary curative surgery. LR size of ≤ 7 cm and TTLR of > 24 months were associated with longer cancer-specific survival. Furthermore, patients with a TTLR of > 24 months had better overall survival and progression-free survival. Of the entire cohort, intraoperative radiation therapy and targeted therapy were used in 17 (18.7%) and 15 (16.5%) patients, respectively. Conclusion Advanced age, T3/T4 stage, Fuhrman grade 3 or 4, major venous infiltration, and positive surgical margins at primary tumor resection were related to a greater risk of early LR. An LR size of ≤ 7 cm and TTLR of > 24 months were associated with favorable oncologic outcomes after LR resection. Thus, patients who present with a longer TTLR and smaller LR size, along with favorable features at primary tumor resection, will benefit from surgical treatment.