Time to Recurrence after Nephrectomy as a Predictor of Cancer-Specific Survival in Localized Clear-Cell Renal Cell Carcinoma

Rodríguez-Covarrubias, Francisco; Gómez-Alvarado, Martha Olivia; Sotomayor, Mariano; Castillejos-Molina, Ricardo; Méndez-Probst, Carlos E.; Gabilondo, Fernando; Feria-Bernal, Guillermo

doi:10.1159/000319368

Cited by 18 publications

(11 citation statements)

References 41 publications

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“…However, up to 20-30% of patients with localized RCC relapse after surgery and usually present with metastatic disease [5]. Prognosis of patients with recurrent disease after localized RCC is poor [6]. Metastatic RCC is an incurable condition.…”

Section: Discussionmentioning

confidence: 99%

Survival Trends among Patients with Advanced Renal Cell Carcinoma in the United States

Shah

Ghimire

2014

Urol Int

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Introduction: Since the approval of sorafenib in December 2005, several targeted therapeutic agents have been approved by the FDA for the treatment of advanced renal cell carcinoma (RCC). This study was conducted to find out whether the improvements in survival of advanced RCC patients with targeted agents have translated into a survival benefit in a population-based cohort. Methods: We analyzed the SEER 18 (Surveillance, Epidemiology and End Results) registry database to calculate the relative survival rates for advanced RCC patients during 2001-2009, 2001-2005, 2006-2007 and 2008-2009. We also evaluated the survival rates by age (<65 and ≥65 years) and sex. Results: The total number of advanced RCC patients during 2001-2009, 2001-2005, 2006-2007 and 2008-2009 were 7,047, 4,059, 1,548 and 1,440, respectively. During 2001-2009, the 1- and 3-year relative survival rates were 26.7 ± 0.6 and 10.0 ± 0.4%, respectively. There was no significant difference in 1-year relative survival rates for patients diagnosed during 2006-2007 and 2008-2009 compared to those diagnosed during 2001-2005. Similarly, the 3-year survival rates for patients diagnosed during 2006-2007 were similar to those diagnosed during 2001-2005. Conclusions: This population-based study showed that there was no significant improvement in relative survival rates among advanced RCC patients in the era of targeted agents.

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Section: Discussionmentioning

confidence: 99%

Survival Trends among Patients with Advanced Renal Cell Carcinoma in the United States

Shah

Ghimire

2014

Urol Int

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“…Other risk factors for early relapse might be tumour size and pathological stage . Moreover, early relapse could be a predictor of secondary recurrence after local relapse surgery . In fact mean relapse time after nephrectomy was 62 months for secondary relapse patients compared with 86 months for patients in complete remission.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and oncological outcomes of laparoscopic treatment for local relapse of renal cell carcinoma

Hajj¹,

Thanigasalam²,

Molinié³

et al. 2013

BJU International

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What's known on the subject? and What does the study add?• Local relapse of renal cell carcinoma following radical nephrectomy is rare, and surgical removal provides the only opportunity for cure. Open surgery has been established as the usual approach for these tumours. It is, however, associated with significant morbidity.• Our study describes the largest series of laparoscopic treatment of local relapse of renal cell carcinoma with the longest follow-up. We show that the laparoscopic approach is feasible in expert centres. It provides faster recovery and fewer complications with satisfactory oncological outcomes in selected patients. Objective• To assess the feasibility and oncological outcomes of laparoscopic treatment for local relapse of renal cell carcinoma. Patients and Methods• Nine patients were treated by a pure laparoscopic approach for local recurrence of a renal tumour between 2005 and 2011 by a single surgeon (HB), following an initial open radical nephrectomy for the primary tumour.• Clinical and histopathological data were collected prospectively and analysed retrospectively.• Seven patients were treated by a transperitoneal approach and two patients had a retroperitoneal approach.

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“…The prognostic influence of time to recurrence (TTR) on cancer‐specific survival (CSS) after disease recurrence is controversial . The consideration that TTR is of prognostic relevance is provided by the Memorial Sloan‐Kettering Cancer Center (MSKCC) score for patients with metastatic RCC, which integrates time from surgery to metastasis with a 12‐month threshold as a prognostic parameter .…”

Section: Introductionmentioning

confidence: 99%

“…The consideration that TTR is of prognostic relevance is provided by the Memorial Sloan‐Kettering Cancer Center (MSKCC) score for patients with metastatic RCC, which integrates time from surgery to metastasis with a 12‐month threshold as a prognostic parameter . Further studies are mainly based on small patient groups and partially suffer from inappropriate endpoints and selection criteria or lack multivariable analysis . Although few prognostic models have been developed to predict recurrence risk, significant knowledge about differences in clinical and histopathological criteria of patients with early and late relapse and about prognostic parameters for CSS after recurrence is lacking .…”

Section: Introductionmentioning

confidence: 99%

“…Further studies are mainly based on small patient groups and partially suffer from inappropriate endpoints and selection criteria or lack multivariable analysis . Although few prognostic models have been developed to predict recurrence risk, significant knowledge about differences in clinical and histopathological criteria of patients with early and late relapse and about prognostic parameters for CSS after recurrence is lacking . As the vast majority of publications on this topic use a 5‐year threshold for distinction of early and late recurrences, we also used this value for analysis of differences in clinical and histopathological criteria between patients with early and late recurrence.…”

Section: Introductionmentioning

confidence: 99%

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Time to recurrence is a significant predictor of cancer‐specific survival after recurrence in patients with recurrent renal cell carcinoma – results from a comprehensive multi‐centre database (CORONA/SATURN‐Project)

et al. 2013

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Objectives To assess the prognostic impact of time to recurrence (TTR) on cancer‐specific survival (CSS) after recurrence in patients with renal cell carcinoma (RCC) undergoing radical nephrectomy or nephron‐sparing surgery. To analyse differences in clinical and histopathological criteria between patients with early and late recurrence. Patients and Methods Of 13 107 patients with RCC from an international multicentre database, 1712 patients developed recurrence in the follow‐up (FU), at a median (interquartile range) of 50.1 (25–106) months. In all, 1402 patients had recurrence at ≤5 years (Group A) and 310 patients beyond this time (Group B). Differences in clinical and histopathological variables between patients with early and late recurrence were analysed. The influence of TTR and further variables on CSS after recurrence was assessed by Cox regression analysis. Results Male gender, advanced age, tumour diameter and stage, Fuhrman grade 3–4, lymphovascular invasion (LVI), and pN + stage were significantly more frequent in patients with early recurrence, who had a significantly reduced 3‐year CSS of 30% compared with patients in Group B (41%; P = 0.001). Age, gender, tumour histology, pT stage, and continuous TTR (hazard ratio 0.99, P = 0.006; monthly interval) independently predicted CSS. By inclusion of dichotomised TTR in the multivariable model, a significant influence of this variable on CSS was present until 48 months after surgery, but not beyond this time. Conclusions Advanced age, male gender, larger tumour diameters, LVI, Fuhrman grade 3–4, pN + stage, and advanced tumour stages are associated with early recurrence. Up to 4 years from surgery, a shorter TTR independently predicts a reduced CSS after recurrence.

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Time to Recurrence after Nephrectomy as a Predictor of Cancer-Specific Survival in Localized Clear-Cell Renal Cell Carcinoma

Cited by 18 publications

References 41 publications

Survival Trends among Patients with Advanced Renal Cell Carcinoma in the United States

Survival Trends among Patients with Advanced Renal Cell Carcinoma in the United States

Feasibility and oncological outcomes of laparoscopic treatment for local relapse of renal cell carcinoma

Time to recurrence is a significant predictor of cancer‐specific survival after recurrence in patients with recurrent renal cell carcinoma – results from a comprehensive multi‐centre database (CORONA/SATURN‐Project)

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