Oncologic Surveillance After Surgical Resection for Renal Cell Carcinoma: A Novel Risk-Based Approach

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Suzanne B Stewart-MerrillIgor Frank

Abstract

The appropriate duration of surveillance for renal cell carcinoma (RCC) after radical or partial nephrectomy remains unknown, and evidence to support current guidelines are lacking. Herein, we provide an approach to surveillance that balances the risk of recurrence versus the risk of non-RCC death. We identified 2,511 patients who underwent surgery for M0 RCC between 1990 and 2008. Patients were stratified for analysis by pathologic stage (pT1Nx-0, pT2Nx-0, pT3/4Nx-0, and pTanyN1), relapse location (abdomen, chest, bone, and other), age (< 50, 50 to 59, 60 to 69, 70-79 and ≥ 80 years), and Charlson comorbidity index (CCI; ≤ 1 and ≥ 2). Risks of disease recurrence and non-RCC death were estimated by using parametric models for time-to-failure with Weibull distributions. Surveillance duration was estimated at the point when the risk of non-RCC death exceeded the risk of recurrence. At a median follow-up of 9.0 years (interquartile range, 6.4 to 12.7 years), a total of 676 patients developed recurrence. By using a competing-risk model, vastly different surveillance durations were appreciated. Specifically, among patients with pT1Nx-0 disease and a CCI ≤ 1, risk of non-RCC death exceeded that of abdominal recurrence risk at 6 month...Continue Reading

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Citations

Jan 19, 2016·The Journal of Urology·Jennifer M LoboTracey L Krupski
Mar 19, 2016·Urologic Oncology·Sean R Williamson, Liang Cheng
Mar 30, 2016·European Urology·Umberto CapitanioFrancesco Montorsi
Sep 14, 2016·Tumour Biology : the Journal of the International Society for Oncodevelopmental Biology and Medicine·Tana MachackovaOndrej Slaby
Nov 3, 2016·BJU International·Alessandro LarcherUmberto Capitanio
Oct 16, 2015·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Naomi B Haas
Dec 23, 2016·Journal of Endourology·Ryan W TubreDavid A Duchene
Mar 10, 2017·Nature Reviews. Disease Primers·James J HsiehVincenzo Ficarra
Feb 19, 2017·Current Urology Reports·Jacqueline M SpeedMaxine Sun
May 17, 2018·World Journal of Urology·Saeed DabestaniAxel Bex
Jan 27, 2018·The Journal of Urology·Paolo CapogrossoUmberto Capitanio
Oct 30, 2018·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Katherine M Krajewski, Ivan Pedrosa
Dec 28, 2018·International Journal of Urology : Official Journal of the Japanese Urological Association·Sebastian K FreesFrederik C Roos
Jul 29, 2016·Current Opinion in Urology·Kyle A Richards, E Jason Abel
Jun 15, 2017·JCI Insight·Jozefina CasuscelliJames J Hsieh
Oct 22, 2020·International Urology and Nephrology·Suzanne B MerrillChristopher S Hollenbeak
Dec 20, 2018·Clinical Genitourinary Cancer·Suzanne B MerrillJay D Raman
Mar 27, 2021·Minerva Urology and Nephrology·Michele RizzoGiovanni Liguori

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