BACKGROUND: Late recurrence of renal cell carcinoma (RCC) is observed in some postoperative patients. In addition, some of these patients are lost to long-term postoperative follow-up. We reviewed the treatment results and prognosis of postoperative patients with RCC at Chiba University Hospital, with the aim of clarifying the proportion and background of patients lost to follow-up. METHODS: This retrospective study included 1176 RCC patients who underwent radical or/and partial nephrectomy. Overall survival (OS), cancer-specific survival (CSS), recurrence-free survival (RFS), and lost follow-up free survival (LFFS) were evaluated and the risk factors for LFFS identified. RESULTS: The median RFS for stage II and II cases was 188.3 and 104.0 months, respectively. Even in stage I, recurrence was observed in about 20% of patients 20 years after surgery. The Kaplan-Meier curve for LFFS showed a linear descent over time, with 50% of patients lost to follow-up within 25 years. Older age (≥ 62 years), histological type (clear cell RCC), and no recurrence were significant risk factors for lost follow-up. CONCLUSIONS: Long-term follow-up is necessary after RCC surgery because late recurrence cases are not uncommon. We believe that lifelong follow-up with imaging studies is recommended for postoperative RCC patients. Early detection of recurrence in postoperative patients is a very important issue, and it may be worthwhile for improving the prognosis of postoperative patients to focus on patients lost to follow-up who may have been overlooked.
BACKGROUND: Late recurrence of renal cell carcinoma (RCC) is observed in some postoperative patients. In addition, some of these patients are lost to long-term postoperative follow-up. We reviewed the treatment results and prognosis of postoperative patients with RCC at Chiba University Hospital, with the aim of clarifying the proportion and background of patients lost to follow-up. METHODS: This retrospective study included 1176 RCC patients who underwent radical or/and partial nephrectomy. Overall survival (OS), cancer-specific survival (CSS), recurrence-free survival (RFS), and lost follow-up free survival (LFFS) were evaluated and the risk factors for LFFS identified. RESULTS: The median RFS for stage II and II cases was 188.3 and 104.0 months, respectively. Even in stage I, recurrence was observed in about 20% of patients 20 years after surgery. The Kaplan-Meier curve for LFFS showed a linear descent over time, with 50% of patients lost to follow-up within 25 years. Older age (≥ 62 years), histological type (clear cell RCC), and no recurrence were significant risk factors for lost follow-up. CONCLUSIONS: Long-term follow-up is necessary after RCC surgery because late recurrence cases are not uncommon. We believe that lifelong follow-up with imaging studies is recommended for postoperative RCC patients. Early detection of recurrence in postoperative patients is a very important issue, and it may be worthwhile for improving the prognosis of postoperative patients to focus on patients lost to follow-up who may have been overlooked.
Authors: Robert J Motzer; Brian I Rini; David F McDermott; Osvaldo Arén Frontera; Hans J Hammers; Michael A Carducci; Pamela Salman; Bernard Escudier; Benoit Beuselinck; Asim Amin; Camillo Porta; Saby George; Victoria Neiman; Sergio Bracarda; Scott S Tykodi; Philippe Barthélémy; Raya Leibowitz-Amit; Elizabeth R Plimack; Sjoukje F Oosting; Bruce Redman; Bohuslav Melichar; Thomas Powles; Paul Nathan; Stéphane Oudard; David Pook; Toni K Choueiri; Frede Donskov; Marc-Oliver Grimm; Howard Gurney; Daniel Y C Heng; Christian K Kollmannsberger; Michael R Harrison; Yoshihiko Tomita; Ignacio Duran; Viktor Grünwald; M Brent McHenry; Sabeen Mekan; Nizar M Tannir Journal: Lancet Oncol Date: 2019-08-16 Impact factor: 41.316
Authors: Sebastian K Frees; Mohammed M Kamal; Sebastian Nestler; Patrick Mf Levien; Samir Bidnur; Walburgis Brenner; Christian Thomas; Wolfgang Jaeger; Joachim W Thüroff; Frederik C Roos Journal: Int J Urol Date: 2018-12-26 Impact factor: 3.369
Authors: Suzanne B Stewart-Merrill; R Houston Thompson; Stephen A Boorjian; Sarah P Psutka; Christine M Lohse; John C Cheville; Bradley C Leibovich; Igor Frank Journal: J Clin Oncol Date: 2015-09-08 Impact factor: 44.544
Authors: Toni K Choueiri; Thomas Powles; Mauricio Burotto; Bernard Escudier; Maria T Bourlon; Bogdan Zurawski; Victor M Oyervides Juárez; James J Hsieh; Umberto Basso; Amishi Y Shah; Cristina Suárez; Alketa Hamzaj; Jeffrey C Goh; Carlos Barrios; Martin Richardet; Camillo Porta; Rubén Kowalyszyn; Juan P Feregrino; Jakub Żołnierek; David Pook; Elizabeth R Kessler; Yoshihiko Tomita; Ryuichi Mizuno; Jens Bedke; Joshua Zhang; Matthew A Maurer; Burcin Simsek; Flavia Ejzykowicz; Gisela M Schwab; Andrea B Apolo; Robert J Motzer Journal: N Engl J Med Date: 2021-03-04 Impact factor: 91.245