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World Journal of Urology
Published in: World Journal of Urology 6/2015

01-06-2015 | Original Article

The blind spots in follow-up after nephrectomy or nephron-sparing surgery for localized renal cell carcinoma

Authors: Tim J. van Oostenbrugge, Stephanie G. C. Kroeze, J. L. H. Ruud Bosch, Harm H. E. van Melick

Published in: World Journal of Urology | Issue 6/2015

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Abstract

Purpose

This study was conducted to identify time to and type of recurrence in relation to scheduled follow-up (FU) imaging after nephrectomy or nephron-sparing surgery for localized renal cell carcinoma (RCC). Using this information, future guidelines could improve the early detection of metastases.

Methods

Measured from moment of treatment, all recurrences after (partial) nephrectomy performed between 2000 and 2010 were categorized as being detected early (<6 months), late (>5 year for T1/T2 and >10 year for T3/T4), or intermediate (time within those two) based on European Association of Urology (EAU) guidelines. Also symptomatic presentation was screened.

Results

Recurrent disease developed in 80 of 396 patients after (partial) tumor nephrectomy. Mean time to recurrence in months was 56 (n = 21) for T1, 24 (n = 18) for T2, 21 (n = 38) for T3, and 11 (n = 2) for T4 tumors. Detection of early recurrence occurred in 22 patients (28 %), of which 20 (91 %) were T2–T4 tumors. In 10 (48 %) of T1 tumors, late recurrence was found. Of the patients with symptoms due to recurrence, 65 % (17/26) were detected outside the FU surveillance protocol (P = 0.01).

Conclusion

A more intensive FU the first 6 months after nephrectomy for T2–T4 and FU imaging ≥5 years after surgery for T1 tumors might improve early and asymptomatic detection of recurrent disease after nephrectomy for RCC.
Literature
1.
2.
Levi F et al (2008) The changing pattern of kidney cancer incidence and mortality in Europe. BJU Int 101(8):949–958CrossRefPubMed
3.
4.
Lightfoot N et al (2000) Impact of noninvasive imaging on increased incidental detection of renal cell carcinoma. Eur Urol 37(5):521–527CrossRefPubMed
5.
Chow WH et al (1999) Rising incidence of renal cell cancer in the United States. JAMA 281(17):1628–1631CrossRefPubMed
6.
Leibovich BC et al (2003) Prediction of progression after radical nephrectomy for patients with clear cell renal cell carcinoma: a stratification tool for prospective clinical trials. Cancer 97(7):1663–1671CrossRefPubMed
7.
Ljungberg B et al (2010) EAU guidelines on renal cell carcinoma: the 2010 update. Eur Urol 58(3):398–406CrossRefPubMed
8.
Donat SM et al (2013) Follow-up for clinically localized renal neoplasms: AUA guideline. J Urol 190(2):407–416CrossRefPubMed
9.
Escudier B et al (2012) Renal cell carcinoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 23(Suppl 7):vii65–vii71CrossRefPubMed
10.
Bruno JJ et al (2006) Renal cell carcinoma local recurrences: impact of surgical treatment and concomitant metastasis on survival. BJU Int 97(5):933–938CrossRefPubMed
11.
Margulis V et al (2009) Predictors of oncological outcome after resection of locally recurrent renal cell carcinoma. J Urol 181(5):2044–2051CrossRefPubMed
12.
Kavolius JP et al (1998) Resection of metastatic renal cell carcinoma. J Clin Oncol 16(6):2261–2266PubMed
13.
Eggener SE et al (2008) Risk score and metastasectomy independently impact prognosis of patients with recurrent renal cell carcinoma. J Urol 180(3):873–878 discussion 878CrossRefPubMedCentralPubMed
14.
Kwak C et al (2007) Metastasectomy without systemic therapy in metastatic renal cell carcinoma: comparison with conservative treatment. Urol Int 79(2):145–151CrossRefPubMed
15.
Alt AL et al (2011) Survival after complete surgical resection of multiple metastases from renal cell carcinoma. Cancer 117(13):2873–2882CrossRefPubMed
16.
Zerbi A et al (2008) Pancreatic metastasis from renal cell carcinoma: which patients benefit from surgical resection? Ann Surg Oncol 15(4):1161–1168CrossRefPubMed
17.
Staehler MD et al (2010) Liver resection for metastatic disease prolongs survival in renal cell carcinoma: 12-year results from a retrospective comparative analysis. World J Urol 28(4):543–547CrossRefPubMed
18.
Piltz S et al (2002) Long-term results after pulmonary resection of renal cell carcinoma metastases. Ann Thorac Surg 73(4):1082–1087CrossRefPubMed
19.
Hofmann HS et al (2005) Prognostic factors and survival after pulmonary resection of metastatic renal cell carcinoma. Eur Urol 48(1):77–82CrossRefPubMed
20.
Murthy SC et al (2005) Can we predict long-term survival after pulmonary metastasectomy for renal cell carcinoma? Ann Thorac Surg 79(3):996–1003CrossRefPubMed
21.
Ljungberg B et al (1999) Follow-up guidelines for nonmetastatic renal cell carcinoma based on the occurrence of metastases after radical nephrectomy. BJU Int 84(4):405–411CrossRefPubMed
22.
Sandock DS, Seftel AD, Resnick MI (1995) A new protocol for the followup of renal cell carcinoma based on pathological stage. J Urol 154(1):28–31CrossRefPubMed
23.
Stephenson AJ et al (2004) Guidelines for the surveillance of localized renal cell carcinoma based on the patterns of relapse after nephrectomy. J Urol 172(1):58–62CrossRefPubMed
24.
Levy DA et al (1998) Stage specific guidelines for surveillance after radical nephrectomy for local renal cell carcinoma. J Urol 159(4):1163–1167CrossRefPubMed
25.
Kim SP et al (2011) Outcomes and clinicopathologic variables associated with late recurrence after nephrectomy for localized renal cell carcinoma. Urology 78(5):1101–1106CrossRefPubMed
26.
Adamy A et al (2011) Clinical characteristics and outcomes of patients with recurrence 5 years after nephrectomy for localized renal cell carcinoma. J Urol 185(2):433–438CrossRefPubMed
27.
Kroeger N et al (2014) Survival outcome and treatment response of patients with late relapse from renal cell carcinoma in the era of targeted therapy. Eur Urol 65(6):1086–1092CrossRefPubMed
Metadata
Title
The blind spots in follow-up after nephrectomy or nephron-sparing surgery for localized renal cell carcinoma
Authors
Tim J. van Oostenbrugge
Stephanie G. C. Kroeze
J. L. H. Ruud Bosch
Harm H. E. van Melick
Publication date
01-06-2015
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 6/2015
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-014-1390-6

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