Advanced

Increased use of cross-sectional imaging for follow-up does not improve post-recurrence survival of surgically treated initially localized R.C.C. : results from a European multicenter database (R.E.C.U.R.)

Dabestani, Saeed LU ; Beisland, Christian; Stewart, Grant D.; Bensalah, Karim; Gudmundsson, Eirikur; Lam, Thomas B.; Gietzmann, William; Zakikhani, Paimaun; Marconi, Lorenzo and Fernandéz-Pello, Sergio, et al. (2019) In Scandinavian Journal of Urology
Abstract

Objective: Modality and frequency of image-based renal cell carcinoma (R.C.C.) follow-up strategies are based on risk of recurrence. Using the R.E.C.U.R.-database, frequency of imaging was studied in regard to prognostic risk groups. Furthermore, it was investigated whether imaging modality utilized in contemporary follow-up were associated with outcome after detection of recurrence. Moreover, outcome was compared based on whether the assessment of potential curability was a pre-defined set of criteria’s (per-protocol) or stated by the investigator. Materials and methods: Consecutive non-metastatic R.C.C. patients (n = 1,612) treated with curative intent at 12 institutes across eight European countries between 2006 and 2011 were... (More)

Objective: Modality and frequency of image-based renal cell carcinoma (R.C.C.) follow-up strategies are based on risk of recurrence. Using the R.E.C.U.R.-database, frequency of imaging was studied in regard to prognostic risk groups. Furthermore, it was investigated whether imaging modality utilized in contemporary follow-up were associated with outcome after detection of recurrence. Moreover, outcome was compared based on whether the assessment of potential curability was a pre-defined set of criteria’s (per-protocol) or stated by the investigator. Materials and methods: Consecutive non-metastatic R.C.C. patients (n = 1,612) treated with curative intent at 12 institutes across eight European countries between 2006 and 2011 were included. Leibovich or U.I.S.S. risk group, recurrence characteristics, imaging modality, frequency and survival were recorded. Primary endpoints were overall survival (O.S.) after detection of recurrence and frequency of features associated with favourable outcome (non-symptomatic recurrences and detection within the follow-up-programme). Results: Recurrence occurred in 336 patients. Within low, intermediate and high risk for recurrence groups, the frequency of follow-up imaging was highest in the early phase of follow-up and decreased significantly over time (p < 0.001). However, neither the image modality for detection nor ≥ 50% cross-sectional imaging during follow-up were associated with improved O.S. after recurrence. Differences between per protocol and investigator based assessment of curability did not translate into differences in O.S. Conclusions: As expected, the frequency of imaging was highest during early follow-up. Cross-sectional imaging use for detection of recurrences following surgery for localized R.C.C. did not improve O.S. post-recurrence. Prospective studies are needed to determine the value of imaging in follow-up.

(Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
follow-up, imaging, overall survival, Renal cell carcinoma
in
Scandinavian Journal of Urology
publisher
Taylor & Francis
external identifiers
  • scopus:85063572781
ISSN
2168-1805
DOI
10.1080/21681805.2019.1588919
language
English
LU publication?
yes
id
5ee01ea4-4138-4b01-9013-c9dd7f4a499d
date added to LUP
2019-04-11 11:02:16
date last changed
2019-04-30 04:11:18
@article{5ee01ea4-4138-4b01-9013-c9dd7f4a499d,
  abstract     = {<p>Objective: Modality and frequency of image-based renal cell carcinoma (R.C.C.) follow-up strategies are based on risk of recurrence. Using the R.E.C.U.R.-database, frequency of imaging was studied in regard to prognostic risk groups. Furthermore, it was investigated whether imaging modality utilized in contemporary follow-up were associated with outcome after detection of recurrence. Moreover, outcome was compared based on whether the assessment of potential curability was a pre-defined set of criteria’s (per-protocol) or stated by the investigator. Materials and methods: Consecutive non-metastatic R.C.C. patients (n = 1,612) treated with curative intent at 12 institutes across eight European countries between 2006 and 2011 were included. Leibovich or U.I.S.S. risk group, recurrence characteristics, imaging modality, frequency and survival were recorded. Primary endpoints were overall survival (O.S.) after detection of recurrence and frequency of features associated with favourable outcome (non-symptomatic recurrences and detection within the follow-up-programme). Results: Recurrence occurred in 336 patients. Within low, intermediate and high risk for recurrence groups, the frequency of follow-up imaging was highest in the early phase of follow-up and decreased significantly over time (p &lt; 0.001). However, neither the image modality for detection nor ≥ 50% cross-sectional imaging during follow-up were associated with improved O.S. after recurrence. Differences between per protocol and investigator based assessment of curability did not translate into differences in O.S. Conclusions: As expected, the frequency of imaging was highest during early follow-up. Cross-sectional imaging use for detection of recurrences following surgery for localized R.C.C. did not improve O.S. post-recurrence. Prospective studies are needed to determine the value of imaging in follow-up.</p>},
  author       = {Dabestani, Saeed and Beisland, Christian and Stewart, Grant D. and Bensalah, Karim and Gudmundsson, Eirikur and Lam, Thomas B. and Gietzmann, William and Zakikhani, Paimaun and Marconi, Lorenzo and Fernandéz-Pello, Sergio and Monagas, Serenella and Williams, Samuel P. and Powles, Thomas and Van Werkhoven, Erik and Meijer, Richard and Volpe, Alessandro and Staehler, Michael and Ljungberg, Börje and Bex, Axel},
  issn         = {2168-1805},
  keyword      = {follow-up,imaging,overall survival,Renal cell carcinoma},
  language     = {eng},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Urology},
  title        = {Increased use of cross-sectional imaging for follow-up does not improve post-recurrence survival of surgically treated initially localized R.C.C. : results from a European multicenter database (R.E.C.U.R.)},
  url          = {http://dx.doi.org/10.1080/21681805.2019.1588919},
  year         = {2019},
}