Targeted therapy response in early versus late recurrence of renal cell carcinoma after surgical treatment: A propensity score-matched study using the Korean Renal Cancer Study Group database.

To investigate the clinicopathological features and outcomes of targeted therapy in patients with recurrence of renal cell carcinoma in <5 years or ≥5 years after the surgical treatment for renal cell carcinoma.

Patients with metastatic renal cell carcinoma treated with targeted therapy in a multicenter database were retrospectively characterized according to time from surgery to recurrence. Early recurrence was defined as recurrence within 5 years after surgery, and late recurrence was defined as occurring ≥5 years after surgery. The propensity scores for recurrence status were calculated, and patients with late recurrence were matched to patients with early recurrence at a 1:3 ratio. The oncological outcomes of targeted therapy in both groups were compared.

Among 716 patients, 512 (71.5%) experienced early recurrence and 204 (28.5%) experienced late recurrence. The patients with late recurrence presented with younger age at surgery, lower tumor stages and Fuhrman grade, and fewer sarcomatoid features and lymphovascular invasion (all P < 0.005). All differences in clinicopathological characteristics before targeted therapy disappeared after matching. Patients with late recurrence had significantly longer median overall survival (56 months vs 36 months; P < 0.0001) and median first-line progression-free survival (12 months vs 8 months; P = 0.031). The early recurrence status was a significantly worse predictor for overall survival and first-line progression-free survival (hazard ratio 1.30, P = 0.007; and hazard ratio 1.76, P < 0.001, respectively).

Late recurrence might have prognostic value in terms of oncological outcomes in metastatic renal cell carcinoma treated with targeted therapy.

International journal of urology : official journal of the Japanese Urological Association. 2021 Feb 01 [Epub ahead of print]

Chan Ho Lee, Jinsoo Chung, Cheol Kwak, Chang Wook Jeong, Seong Il Seo, Minyong Kang, Sung-Hoo Hong, Cheryn Song, Jae Young Park, Eu Chang Hwang, Hakmin Lee, Ja Yoon Ku, Won Ik Seo, Seock Hwan Choi, Hong Koo Ha, Korean Renal Cancer Study Group

Department of Urology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea., Urologic Oncology Clinic, National Cancer Center, Goyang, Korea., Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea., Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea., Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea., Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea., Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea., Department of Urology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea., Department of Urology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea., Department of Urology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea., Department of Urology, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea.