OBJECTIVE: To present our results on managing loco-regional recurrence of renal cell carcinoma (RCC) with surgical excision, as local recurrence at the site of a previous nephrectomy is resistant to both systemic therapy and radiotherapy. PATIENTS AND METHODS: In all, 16 patients were operated on between 1994 and 2003 for local recurrence of RCC. The median (mean, range) age at the time of local recurrence was 57.9 (57.4, 28.9-71.7) years, and the median interval from primary surgery 2.22 (3.88, 0.27-14.46) years. Before surgery eight patients had been given systemic immunotherapy, with no response of their local recurrence. RESULTS: Two patients were deemed inoperable because of direct invasion of the great vessels and the liver by tumour. The remaining 14 patients had recurrence in residual adrenal tissue (two), para-aortic nodes (three), para-caval nodes (two), retrocaval nodes (one), renal bed (six), liver, spleen and stomach (one each), and diaphragm (two). Although complete macroscopic en-bloc clearance was achieved in these patients, only eight had tumour-free margins on histological examination. The histology was consistent with RCC recurrence in all cases. All of the patients were followed with computed tomography at regular intervals. At a median follow-up of 1.0 (1.65, 0.25-6.5) years, five patients remain disease-free, four have local and distant relapse, and five developed distant metastasis only. The presence of tumour at the resection margin was a significant factor in predicting local and distant disease-free survival (P < 0.05). CONCLUSIONS: En bloc excision of isolated locally recurrent RCC is possible, and complete surgical extirpation can lead to prolonged disease-free survival.
OBJECTIVE: To present our results on managing loco-regional recurrence of renal cell carcinoma (RCC) with surgical excision, as local recurrence at the site of a previous nephrectomy is resistant to both systemic therapy and radiotherapy. PATIENTS AND METHODS: In all, 16 patients were operated on between 1994 and 2003 for local recurrence of RCC. The median (mean, range) age at the time of local recurrence was 57.9 (57.4, 28.9-71.7) years, and the median interval from primary surgery 2.22 (3.88, 0.27-14.46) years. Before surgery eight patients had been given systemic immunotherapy, with no response of their local recurrence. RESULTS: Two patients were deemed inoperable because of direct invasion of the great vessels and the liver by tumour. The remaining 14 patients had recurrence in residual adrenal tissue (two), para-aortic nodes (three), para-caval nodes (two), retrocaval nodes (one), renal bed (six), liver, spleen and stomach (one each), and diaphragm (two). Although complete macroscopic en-bloc clearance was achieved in these patients, only eight had tumour-free margins on histological examination. The histology was consistent with RCC recurrence in all cases. All of the patients were followed with computed tomography at regular intervals. At a median follow-up of 1.0 (1.65, 0.25-6.5) years, five patients remain disease-free, four have local and distant relapse, and five developed distant metastasis only. The presence of tumour at the resection margin was a significant factor in predicting local and distant disease-free survival (P < 0.05). CONCLUSIONS: En bloc excision of isolated locally recurrent RCC is possible, and complete surgical extirpation can lead to prolonged disease-free survival.
Authors: Wassim Kassouf; Robert Siemens; Christopher Morash; Louis Lacombe; Michael Jewett; Larry Goldenberg; Joseph Chin; Michael Chetner; Christopher G Wood; Simon Tanguay; Armen G Aprikian Journal: Can Urol Assoc J Date: 2009-02 Impact factor: 1.862
Authors: Ziho Lee; Opeyemi A Jegede; Naomi B Haas; Michael R Pins; Edward M Messing; Judith Manola; Christopher G Wood; Christopher J Kane; Michael A S Jewett; Keith T Flaherty; Janice P Dutcher; Robert S DiPaola; Robert G Uzzo Journal: J Urol Date: 2019-10-09 Impact factor: 7.450
Authors: B Schlenker; M Seitz; M J Bader; R Ganzer; D Tilki; F Bayrle; O Reich; M Staehler; A Bachmann; C G Stief; C Gratzke Journal: Eur J Med Res Date: 2010-06-28 Impact factor: 2.175
Authors: Arun Z Thomas; Mehrad Adibi; Leonardo D Borregales; Ly N Hoang; Pheroze Tamboli; Eric Jonasch; Nizar M Tannir; Surena F Matin; Christopher G Wood; Jose A Karam Journal: J Urol Date: 2015-03-07 Impact factor: 7.450