Pattern, timing and predictors of recurrence after surgical resection of chromophobe renal cell carcinoma
(2021) In World Journal of Urology 39(10). p.3823-3831- Abstract
Purpose: Currently there are no specific guidelines for the post-operative follow-up of chromophobe renal cell carcinoma (chRCC). We aimed to evaluate the pattern, location and timing of recurrence after surgery for non-metastatic chRCC and establish predictors of recurrence and cancer-specific death. Methods: Retrospective analysis of consecutive surgically treated non-metastatic chRCC cases from the Royal Free London NHS Foundation Trust (UK, 2015–2019) and the international collaborative database RECUR (15 institutes, 2006–2011). Kaplan–Meier curves were plotted. The association between variables of interest and outcomes were analysed using univariate and multivariate Cox proportional hazards regression models with shared frailty for... (More)
Purpose: Currently there are no specific guidelines for the post-operative follow-up of chromophobe renal cell carcinoma (chRCC). We aimed to evaluate the pattern, location and timing of recurrence after surgery for non-metastatic chRCC and establish predictors of recurrence and cancer-specific death. Methods: Retrospective analysis of consecutive surgically treated non-metastatic chRCC cases from the Royal Free London NHS Foundation Trust (UK, 2015–2019) and the international collaborative database RECUR (15 institutes, 2006–2011). Kaplan–Meier curves were plotted. The association between variables of interest and outcomes were analysed using univariate and multivariate Cox proportional hazards regression models with shared frailty for data source. Results: 295 patients were identified. Median follow-up was 58 months. The five and ten-year recurrence-free survival rates were 94.3% and 89.2%. Seventeen patients (5.7%) developed recurrent disease, 13 (76.5%) with distant metastases. 54% of metastatic disease diagnoses involved a single organ, most commonly the bone. Early recurrence (< 24 months) was observed in 8 cases, all staged ≥ pT2b. 30 deaths occurred, of which 11 were attributed to chRCC. Sarcomatoid differentiation was rare (n = 4) but associated with recurrence and cancer-specific death on univariate analysis. On multivariate analysis, UICC/AJCC T-stage ≥ pT2b, presence of coagulative necrosis, and positive surgical margins were predictors of recurrence and cancer-specific death. Conclusion: Recurrence and death after surgically resected chRCC are rare. For completely excised lesions ≤ pT2a without coagulative necrosis or sarcomatoid features, prognosis is excellent. These patients should be reassured and follow-up intensity curtailed.
(Less)
- author
- author collaboration
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Chromophobe renal cell carcinoma, Follow-up, Nephrectomy, Renal cell carcinoma, Survival
- in
- World Journal of Urology
- volume
- 39
- issue
- 10
- pages
- 3823 - 3831
- publisher
- Springer
- external identifiers
-
- scopus:85104286174
- pmid:33851271
- ISSN
- 0724-4983
- DOI
- 10.1007/s00345-021-03683-9
- language
- English
- LU publication?
- yes
- id
- 4faad6dd-a29d-45e9-861d-37748b6fb18b
- date added to LUP
- 2021-04-27 09:40:13
- date last changed
- 2024-06-15 10:33:48
@article{4faad6dd-a29d-45e9-861d-37748b6fb18b,
abstract = {{<p>Purpose: Currently there are no specific guidelines for the post-operative follow-up of chromophobe renal cell carcinoma (chRCC). We aimed to evaluate the pattern, location and timing of recurrence after surgery for non-metastatic chRCC and establish predictors of recurrence and cancer-specific death. Methods: Retrospective analysis of consecutive surgically treated non-metastatic chRCC cases from the Royal Free London NHS Foundation Trust (UK, 2015–2019) and the international collaborative database RECUR (15 institutes, 2006–2011). Kaplan–Meier curves were plotted. The association between variables of interest and outcomes were analysed using univariate and multivariate Cox proportional hazards regression models with shared frailty for data source. Results: 295 patients were identified. Median follow-up was 58 months. The five and ten-year recurrence-free survival rates were 94.3% and 89.2%. Seventeen patients (5.7%) developed recurrent disease, 13 (76.5%) with distant metastases. 54% of metastatic disease diagnoses involved a single organ, most commonly the bone. Early recurrence (< 24 months) was observed in 8 cases, all staged ≥ pT2b. 30 deaths occurred, of which 11 were attributed to chRCC. Sarcomatoid differentiation was rare (n = 4) but associated with recurrence and cancer-specific death on univariate analysis. On multivariate analysis, UICC/AJCC T-stage ≥ pT2b, presence of coagulative necrosis, and positive surgical margins were predictors of recurrence and cancer-specific death. Conclusion: Recurrence and death after surgically resected chRCC are rare. For completely excised lesions ≤ pT2a without coagulative necrosis or sarcomatoid features, prognosis is excellent. These patients should be reassured and follow-up intensity curtailed.</p>}},
author = {{Neves, Joana B. and Vanaclocha Saiz, Leyre and Abu-Ghanem, Yasmin and Marchetti, Marta and Tran-Dang, My Anh and El-Sheikh, Soha and Barod, Ravi and Beisland, Christian and Capitanio, Umberto and Cullen, David and Klatte, Tobias and Ljungberg, Börje and Mumtaz, Faiz and Patki, Prasad and Stewart, Grant D. and Dabestani, Saeed and Tran, Maxine G.B. and Bex, Axel}},
issn = {{0724-4983}},
keywords = {{Chromophobe renal cell carcinoma; Follow-up; Nephrectomy; Renal cell carcinoma; Survival}},
language = {{eng}},
number = {{10}},
pages = {{3823--3831}},
publisher = {{Springer}},
series = {{World Journal of Urology}},
title = {{Pattern, timing and predictors of recurrence after surgical resection of chromophobe renal cell carcinoma}},
url = {{http://dx.doi.org/10.1007/s00345-021-03683-9}},
doi = {{10.1007/s00345-021-03683-9}},
volume = {{39}},
year = {{2021}},
}