UP-45 Disease recurrence patterns in high-risk nonmetastatic renal cell carcinoma patients post-nephrectomy with long-term follow-up
Thursday June 27, 2019 from
TBD
Award Winner
Shipra Taneja, Canada has been granted the
Presenter

Shipra Taneja, Canada

Research Assistant/Student

Department of Surgery - Division of Urology

McMaster University

Abstract

Disease recurrence patterns in high-risk nonmetastatic renal cell carcinoma patients post-nephrectomy with long-term follow-up

Shipra Taneja1, Jen Hoogenes1, Anil Kapoor1.

1Department of Surgery, Division of Urology, McMaster University, Hamilton, ON, Canada

Urologic Cancer Centre for Research and Innovation, St. Joseph's Healthcare Hamilton.

Introduction: Guidelines recommend intermediate and high-risk renal cell carcinoma (RCC) patient monitoring for up to 5 years; however, some long-term studies have found disease recurrence among the high-risk population after the 5-year mark. Our objective was to determine patterns of recurrence among high-risk non-metastatic RCC (HRnmRCC) patients up to15 years post-radical nephrectomy.

Methods: This was a single-centre retrospective chart review of HRnmRCC patients who underwent radical nephrectomy between January 2000 and December 2015. Patients on registered clinical trials for adjuvant therapy or with fewer than 3 years follow-up were excluded. The primary outcome measure was progression-free survival (PFS), with evaluation of prognostic factors including surgical approach, tumour histology and grade, and margin status.

Results: 50 patients met the inclusion criteria and had complete data. Mean age at baseline was 70.3 (±12.6), with a median of 71 years (range 41-97), and 32 were male. 70% had laparoscopic radical nephrectomy while the rest had open radical nephrectomy. 86% had clear cell RCC (ccRCC), 4 had papillary, 2 chromophobe, and 1 sarcomatoid. The most common stages were T3aNXMX and T3aNOMX (28% each), with 90% having negative margins. A total of 22 patients (16 male) had recurrence with a median of 28 months (range 7-94). The median age of patients who progressed was 69.5 (range 41-87 years) and 91% had ccRCC. 68% of patients had recurrence in the lung, with 50% having multiple locations. On Kaplan-Meier log rank tests, no factors played a significant role in recurrence.

Conclusions: Our results highlight the importance of follow-up for HRnmRCC patients beyond 5 years post-nephrectomy. Our preliminary data suggest that 44% (22/50) can have recurrence up to 8 years post-nephrectomy. While this is a small sample size going back to 2000, these preliminary data would suggest that HRnmRCC (T3/T4) should have routine follow-up beyond 5 years.


© 2022 CUA 74th Annual Meeting