Predictors of Cancer-specific Survival After Disease Recurrence in Patients With Renal Cell Carcinoma: The Effect of Time to Recurrence

A few studies addressed predictive factors of cancer-specific mortality (CSM) in patients with recurrent renal cell carcinoma (RCC) following surgery. Time to recurrence (TTR) is an important predictor of CSM in various types of cancers. The aim of our study was to describe the course of RCC following disease recurrence and to identify prognostic factors that influence CSM with a special focus on TTR.

Retrospective analysis of 331 patients who experienced disease recurrence after radical nephrectomy (n = 307) or partial nephrectomy (n = 24) with curative intent. A Cox proportional hazards regression model addressed the association between various clinicopathologic features and CSM after disease recurrence. TTR was defined as time from surgery to occurrence of disease recurrence.

Of the 331 patients, 232 (70%) were male, and 99 (30%) were female. The median age at surgery was 62 years (interquartile range, 53-69 years). Median time from nephrectomy to disease recurrence was 1.2 years (interquartile range, 0.5-3.3 years). Of the recurrences, 63 (19%) were local, and 268 (81%) were distant. Shorter time to recurrence (P = .0008), female gender (P = .035), and distant versus local recurrence location (P < .0001) were found to be independently associated with CSM following disease recurrence.

In patients experiencing disease recurrence after nephrectomy for presumably localized RCC, shorter TTR, female gender, and distant recurrence were found to be associated with worse CSM. The inclusion of these factors into risk-stratification tools may help patient counseling and decision-making regarding type and regimen of salvage treatment.

Clinical genitourinary cancer. 2018 Mar 24 [Epub ahead of print]

Malte Rieken, Luis A Kluth, Harun Fajkovic, Umberto Capitanio, Alberto Briganti, Laura-Maria Krabbe, Vitaly Margulis, Mohammad Abufaraj, Andrea Mari, Beat Foerster, Jay D Raman, Mikhail Regelman, Sabine Brookman-May, Daniel D Sjoberg, Pierre I Karakiewicz, Shahrokh F Shariat

Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY; Department of Urology, Medical University of Vienna, Vienna, Austria., Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Department of Urology, Medical University of Vienna, Vienna, Austria., Department of Urology, Vita-Salute University San Raffaele, Milan, Italy., Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX; Department of Urology, University of Münster Medical Center, Münster, Germany., Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX., Department of Urology, Medical University of Vienna, Vienna, Austria; Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan., Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Careggi Hospital, University of Florence, Florence, Italy., Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Kantonsspital Winterthur, Winterthur, Switzerland., Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, PA., Department of Urology, Ludwig-Maximilians-University Munich, Campus Grosshadern, Munich, Germany., Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY., Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Quebec, Canada., Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY; Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria. Electronic address: .

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