Local recurrence after nephron-sparing therapy in Sweden, a register based study

• Background: In the Swedish Kidney Cancer Registry 99% of all patients nationwide are reported. The aim of this study is to present results of occurrence of recurrences in the treated kidney after nephron sparing treatments in patients with T1aN0M0 renal cell carcinoma (RCC) and their overall survival.Material: Since 2005 around 14.000 patients have been included prospectively in the National Swedish Kidney Cancer Register. Among those patients there were 5013 out of 5311 patients (94%) without metastatic disease that had a follow-up checkup 5 years after diagnosis. Among the 5013 patients, 39 had unclear recurrence data and were excluded from the analysis. Statistical analysis was done by SPSS 24. SCANDINAVIAN JOURNAL OF UROLOGY 27Results: In total, 1015 (19.9%) had recurrent disease during 5 years follow-up. During the time of diagnosis (2005 -2012,) 1077 patients were treated with nephron sparing treatment: 947 with partial nephrectomy (PN), 114 with radiofrequency ablation (RF) and 16 with other treatments. Among pT1a patients 16 of 712 treated with PN (1.7%) had a local recurrence compared with 13 of 105, (12.3%) RF patients. PN Patients had significantly better overall survival than RF patients. However RF patients were significantly older than PN (67.7 vs 60.6 years, p< 0.0001). Also tumor size was larger in PN (27.3 VS 24.4 MM, P< 0.001) as well as longer follow-up-time 8.1 versus 7.1 years. All PNs had a verified histology while only 97 out of 114 tumors treated with RF had a verified histology (85%).Conclusion: Conclusions. In this population-based study, 19.9% with M0 disease recurred within 5 years. Patients with T1a tumors treated with RF had significantly more frequently local recurrence than PN patients. Furthermore, patients with RF treatment had a significantly shorter overall survival but were older. In contrast, patients treated with PN had larger tumors, had longer follow-up time and were all histology proven. The significance of these observations might be important.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Urology and Nephrology (hsv//eng)

Publikations- och innehållstyp

vet (ämneskategori)

art (ämneskategori)