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

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

doi:10.1016/j.juro.2010.09.100

Cited by 78 publications

(69 citation statements)

References 21 publications

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“…13 Furthermore, a noteworthy portion of our cohort (33%) developed pancreatic metastases that have been shown to be more common in the late-relapse population, 6 and the pancreas is a metastatic site known to be associated with extended survival in patients with mRCC.…”

Section: Discussionmentioning

confidence: 93%

“…5 Studies have characterized patients with late relapse, occurring after a disease-free interval >5 years, in terms of patient and tumor prognostic features to adjust surveillance protocols and increase the length of surveillance in patients with an increased propensity to relapse after 5 years. 6,7 A 5-year disease-free interval is most commonly used to define the late-relapse population and has been shown to be the most useful interval length in clinical practice. 7 The prognosis and response to targeted therapies of patients with late relapse are less studied.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes of patients with late relapse metastatic renal cell carcinoma treated with targeted therapies: A single-institution experience.

Mandalapu

Matrana

Poosarla

2015

JCO

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Background: Late relapse with presentation of metastatic disease >5 years after nephrectomy with curative intent is a known behavior of renal cell carcinoma (RCC), but data on outcomes, especially regarding targeted therapies, are limited. In this study, we analyze clinicopathologic features and response to targeted therapy in patients with late-relapse metastatic RCC (mRCC). Methods: We retrospectively reviewed clinical data on consecutive patients treated with targeted therapy for mRCC diagnosed >5 years after nephrectomy with curative intent. Results: A total of 24 patients (100% clear cell histology, median age 72 years, 83% males, all with prior nephrectomies) met inclusion criteria; 71% had favorable risk, and 25% had intermediate risk by International Metastatic Renal Cell Carcinoma Database Consortium criteria. The estimated median overall survival for all patients was 60.5 months, and the 3-year overall survival rate was 71.78% (95% confidence interval, 47.98%-84.77%). All patients were treated with targeted therapy; first-line treatments included pazopanib (46%), sorafenib (25%), sunitinib (17%), and cytokine (13%), with no significant difference in time to treatment failure between therapies. Median time on first-line therapy was 19.7 months; 67% of patients received second-line treatment. Metastases were detected at considerable rates in sites considered historically uncommon, such as the pancreas, adrenal glands, and soft tissue. Conclusion: Patients with late-relapse mRCC treated with targeted therapy had prolonged survival that compared favorably to historical controls, and metastases in uncommon sites were noted.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Outcomes of patients with late relapse metastatic renal cell carcinoma treated with targeted therapies: A single-institution experience.

Mandalapu

Matrana

Poosarla

2015

JCO

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“…After an initial 5-year postoperative disease free interval the late recurrence rate was reported as 6-20% (8,13). The most recurrences were distant rather than local.…”

Section: Discussionmentioning

confidence: 99%

Solitary Cerebral Metastases from Renal Cell Carcinoma 16 years After Nephrectomy

Gümüşay¹,

Benekli²,

Algın³

et al. 2014

Acta Oncol Tur.

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ÖZETTanıdan l0 yıl sonar gelişen local nüks ve uzak metastaz, renal hücreli kanserin (RCC) geç rekkürrensi olarak adlandırılır. Geç rekürrens %4.7-11 oranında görülmektedir. Bu olgu sunumunda RCC nedeniyle nefrektomi yapılan ve 16 yıl sonra soliter beyin metastazı gelişen 54 yaşındaki kadın hastayı tartışmayı amaçladık. İntrakranial tumor nedeni ile gross total eksizyon yapıldı. Patolojik tanısı RCC metastazı olarak saptandı. Yapılan immune histokimyasal incelemede beyin metastazı ile 16 yıl once yapılan nefrektomi patolojisinin aynı olduğu saptandı. Postoperatif hastaya gamma-knife uygulandı. Hastaya interferon başlandı. Erken evre RCC hastalarında da yıllık kontrollerin >10 yıl sonra da devam edilmesi ile nüksün erken saptanması ile cerrahi rezeksiyon şansı sağlayabilir. Gelecekte yapılan çalışmalarla, gerçekkürens gelişiminde rolalan risk faktörlerinin belirlenmesi uzun takip süresi gereken hastalaları belirleme de katkı sağlayacaktır. Anahtar Kelimeler: Geç Rekürrens; Renal Hücreli Kanser; Beyin Metastazı ABSTRACT Late recurrence of RCC was described as developing local recurrence or distant metastasis with a latency period of more than 10 years after nephrectomy. The rate of late recurrence after nephrectomy ranges from 4.7% to 11%. Here we report the case of a 54 year-old white female with RCC who developed brain metastasis 16 years after nephrectomy. Gross total resection of intracranial tumor was performed. Histologic examination and immunohistochemical profile of the primary renal tumor and metastatic cranial tumor showed identical morphology and immunophenotype. She was treated with gamma knife stereotactic radiosurgery. Postoperatively, the patient received interferon. Long term surveillance in RCC could be important for earlier detection of recurrence and provide chance for surgical resection. Future studies and long follow up are needed to identify risk factors for late recurrence in patients with RCC.

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“…Most recurrences are distant rather than local. [82][83][84] The largest study evaluating relapse after 5 years following nephrectomy demonstrated lymphovascular invasion, Furhman grade 3 or 4, and pathologic tumour stage >pT1 as independent predictors of late recurrence. In addition, late recurrence was approximately 2.6%, 5%, 9%, 10%, 11% and 22% for T1a, T1b, T2a, T2b, T3a and T3b respectively.…”

Section: Cuaj -Cua Guidelinementioning

confidence: 99%

Canadian Urological Association guideline for followup of patients after treatment of non-metastatic renal cell carcinoma

Kassouf

Monteiro

Drachenberg

et al. 2018

CUAJ

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

Cited by 78 publications

References 21 publications

Outcomes of patients with late relapse metastatic renal cell carcinoma treated with targeted therapies: A single-institution experience.

Outcomes of patients with late relapse metastatic renal cell carcinoma treated with targeted therapies: A single-institution experience.

Solitary Cerebral Metastases from Renal Cell Carcinoma 16 years After Nephrectomy

Canadian Urological Association guideline for followup of patients after treatment of non-metastatic renal cell carcinoma

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