BACKGROUND: The purpose of this study was to identify predictive factors for late recurrence in Korean patients with stage T1 clear cell renal cell carcinoma (RCC) more than 5 years after treatment with radical nephrectomy (RN) or partial nephrectomy (PN).
PATIENTS AND METHODS: Between 1999 and 2011, 3567 patients with RCC underwent RN or PN at 5 institutions in Korea. Of these, 423 patients with pathologically confirmed stage T1 clear cell RCC remained free of disease for at least 5 years. To determine the pathologic and clinical factors that influenced late recurrence, univariate and multivariate analyses using the Cox proportional hazards model were performed. Recurrence-free survival curves were estimated by using the Kaplan-Meier method.
RESULTS: During a median follow-up period of 83.9 months (range 60.0-156.4 months), late recurrence was observed in 14 of the 423 (3.3%) patients. Univariate and multivariate analyses revealed that symptoms at diagnosis and pathologic T stage were independent predictive factors for late recurrence. Patients with symptoms at diagnosis or stage T1b disease had a significantly shorter time to late recurrence than did those who were asymptomatic or had stage T1a disease (log-rank test P = .027 and P = .034, respectively).
CONCLUSIONS: Late recurrence in stage T1 clear cell RCC is a relatively rare event. Predictive factors for late recurrence were identified in the present study. Careful long-term follow-up is necessary, especially in patients who have symptoms at diagnosis or stage T1b tumors, even if they have been free of disease for more than 5 years.
Written by:
Ha YS, Park YH, Kang SH, Hong SH, Hwang TK, Byun SS, Kim YJ. Are you the author?
Department of Urology, Chungbuk National University College of Medicine, Cheongju, Korea; Section of Urologic Oncology and Dean and Betty Gallo Prostate Cancer Center, the Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ.
Reference: Clin Genitourin Cancer. 2012 Sep 25. pii: S1558-7673(12)00175-9.
doi: 10.1016/j.clgc.2012.08.008
PubMed Abstract
PMID: 23017336
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