Renal cell carcinoma local recurrences: impact of surgical treatment and concomitant metastasis on survival

BJU International
J James BrunoPaul Russo

Abstract

To analyse the survival benefit of resecting local recurrence (LR) of renal cell carcinoma (RCC) in the presence and absence of concomitant metastasis. From 1989 to 2004 we identified 34 patients with LRs (2.9%) of the 1165 radical nephrectomies performed for T1-4N0M0 disease. Of these, 18 (53%) had no evidence of metastasis (isolated LR incidence, 1.5%) and 16 (47%) had synchronous metastasis. Of the 18 patients with no metastasis, 11 had complete surgical resection (group I) and seven had nonsurgical therapy (group II). Of the 16 patients with synchronous metastasis, five had surgery (group III) and 11 did not (group IV). Survival was projected using the Kaplan-Meier method and log-rank test for each group. Eight of the 34 patients (24%) were symptomatic. The T stage of the initial nephrectomy was T1a in two cases, T1b in six, T2 in five, T3a in six, T3b in eight, T4 in six and unknown in one; 22 patients (65%) had clear cell histology. There were no significant differences in median time to LR or the LR size among the groups. The median (range) follow-up was 16.9 (0.5-103.6) months. Of the 11 patients in group I, three remain with no evidence of disease, three are alive with metastatic disease, and five died from disease. By...Continue Reading

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Citations

May 15, 2008·Nature Clinical Practice. Urology·John S LamPeter G Schulam
May 21, 2008·Nature Clinical Practice. Urology·Timothy A Masterson, Paul Russo
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