Time to Recurrence after Nephrectomy as a Predictor of Cancer-Specific Survival in Localized Clear-Cell Renal Cell CarcinomaRodriguez-Covarrubias F. · Gomez-Alvarado M.O. · Sotomayor M. · Castillejos-Molina R. · Mendez-Probst C.E. · Gabilondo F. · Feria-Bernal G.
Department of Urology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
Do you have an account?
- Rent for 48h to view
- Buy Cloud Access for unlimited viewing via different devices
- Synchronizing in the ReadCube Cloud
- Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00
Article / Publication Details
Objective: To evaluate the prognostic impact of early recurrence (within 12 months) after surgery on cancer-specific survival (CSS) of patients with localized clear-cell renal cell carcinoma (ccRCC). Methods: Patients with surgically treated localized ccRCC were studied. Using the Kaplan-Meier method, we calculated CSS; by univariate and multivariate models we analyzed the association of early recurrence with cancer-related mortality. Results: We identified 259 patients with pT1–4/NX/0M0 ccRCC treated between February 1981 and September 2009; of 66 (25.5%) with disease recurrence, 29 (43.9%) had early relapse. Overall, 43 patients (16.6%) died from ccRCC. The 5- and 10-year CSS for those without, late and early recurrence was 98.5 and 96.5%, 53 and 39.8%, and 23 and 23%, respectively (p < 0.0001). In the multivariate Cox model, pT stage (p = 0.01) and early recurrence (p < 0.0001) independently predicted CSS. Conclusions: Recurrent disease after localized ccRCC confers a poor prognosis, especially if detected within 12 months after surgery. Thus, this criterion should be included as an independent risk factor for cancer-related mortality.
© 2010 S. Karger AG, Basel
- Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ: Cancer statistics, 2007. CA Cancer J Clin 2007;57:43–66.
- Aron M, Nguyen MM, Stein RJ, Gill IS: Impact of gender in renal cell carcinoma: an analysis of the SEER database. Eur Urol 2008;54:133–140.
- Kovacs G, Akhtar M, Beckwith BJ, et al: The Heidelberg classification of renal cell tumors. J Pathol 1997;183:131–133.
- Rodríguez-Covarrubias F, Gabilondo B, Borgen JL, Gabilondo F: Partial nephrectomy for renal tumors using selective parenchymal clamping. Int Urol Nephrol 2007;39:43–46.
- Drucker BJ: Renal cell carcinoma: current status and future prospects. Cancer Treat Rev 2005;31:536–545.
- Lam JS, Shvarts O, Leppert JT, Figlin RA, Belldegrun AS: Renal cell carcinoma 2005: new frontiers in staging, prognostication and targeted molecular therapy. J Urol 2005;173:1853–1862.
- Stephenson AJ, Chetner MP, Rourke K, et al: Guidelines for the surveillance of localized renal cell carcinoma based on the patterns of relapse after nephrectomy. J Urol 2004;172:58–62.
- Janzen NK, Kim HL, Figlin RA, Belldegrun AS: Surveillance after radical or partial nephrectomy for localized renal cell carcinoma and management of recurrent disease. Urol Clin North Am 2003;30:843–852.
- Ficarra V: Re: Renal cell carcinoma recurrence after nephrectomy for localized disease: predicting survival from time of recurrence. Eur Urol 2007;51:283.
- Lane BR, Kattan MW: Prognostic models and algorithms in renal cell carcinoma. Urol Clin North Am 2008;35:613–625.
- Magera JS, Leibovich BC, Lohse CM, et al: Association of abnormal preoperative laboratory values with survival after radical nephrectomy for clinically confined clear cell renal cell carcinoma. Urology 2008;71:278–282.
- Freedland SJ, Humphreys EB, Mangold LA, Eisenberger M, Partin AW: Time to prostate specific antigen recurrence after radical prostatectomy and risk of prostate cancer specific mortality. J Urol 2006;176:1404–1408.
- Eggener S, Yossepowitch O, Pettus J, Snyder ME, Motzer RJ, Russo P: Renal cell carcinoma recurrence after nephrectomy for localized disease: predicting survival from time of recurrence. J Clin Oncol 2006;24:3101–3106.
- Knight DA, Stadler WM: Prognostic factors in localized renal cell cancer. BJU Int 2007;99:1212–1216.
- Motzer RJ, Mazumdar M, Bacik J, Berg W, Amsterdam A, Ferrara J: Survival and prognostic stratification of 670 patients with advanced renal cell carcinoma. J Clin Oncol 1999;17:2530–2540.
- Cheville JC, Lohse CM, Zincke H, et al: Sarcomatoid renal cell carcinoma: an examination of underlying histologic subtype and an analysis of associations with patient outcome. Am J Surg Pathol 2004;28:435–441.
- Margulis V, Tamboli P, Matin SF, Meisner M, Swanson DA, Wood CG: Location of extrarenal tumor extension does not impact survival of patients with pT3a renal cell carcinoma. J Urol 2007;178:1878–1882.
- Rodríguez-Covarrubias F, Castillejos-Molina R, Sotomayor M, et al: Impact of lymph node invasion and sarcomatoid differentiation on the survival of patients with locally advanced renal cell carcinoma. Urol Int 2010;85:23–29.
- Sorbellini M, Kattan MW, Snyder ME, et al: A postoperative prognostic nomogram predicting recurrence for patients with conventional clear cell renal cell carcinoma. J Urol 2005;173:48–51.
- Zisman A, Pantuck AJ, Wieder J, et al: Risk group assessment and clinical outcome algorithm to predict the natural history of patients with surgically resected renal cell carcinoma. J Clin Oncol 2002;20:4559–4566.
- Patard JJ, Kim HL, Lam JS, et al: Use of the University of California Los Angeles integrated staging system to predict survival in renal cell carcinoma: an international multicenter study. J Clin Oncol 2004;22:3316–3322.
Article / Publication Details
Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.