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Long-term Outcomes ...
Long-term Outcomes of Follow-up for Initially Localised Clear Cell Renal Cell Carcinoma : RECUR Database Analysis
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- Dabestani, Saeed (författare)
- Lund University,Lunds universitet,Urologi,Forskargrupper vid Lunds universitet,Urology,Lund University Research Groups,Skåne University Hospital
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- Beisland, Christian (författare)
- University of Bergen
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- Stewart, Grant D. (författare)
- University of Cambridge
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- Bensalah, Karim (författare)
- University of Rennes I
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- Gudmundsson, Eirikur (författare)
- National University Hospital of Iceland
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- Lam, Thomas B. (författare)
- University of Aberdeen
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- Gietzmann, William (författare)
- University of Aberdeen
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- Zakikhani, Paimaun (författare)
- University of Aberdeen
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- Marconi, Lorenzo (författare)
- University Hospital of Coimbra
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- Fernandéz-Pello, Sergio (författare)
- University Hospital Cabueñes
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- Monagas, Serenella (författare)
- San Agustin University Hospital
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- Williams, Samuel P. (författare)
- University of Edinburgh
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- Torbrand, Christian (författare)
- Lund University,Lunds universitet,Oftalmologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Ophthalmology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Powles, Thomas (författare)
- Queen Mary University
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- Van Werkhoven, Erik (författare)
- Netherlands Cancer Institute
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- Meijer, Richard (författare)
- University Medical Center Utrecht
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- Volpe, Alessandro (författare)
- University of Eastern Piedmont
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- Staehler, Michael (författare)
- German Center for Lung Research (DZL)
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- Ljungberg, Börje, 1949- (författare)
- Umeå University,Umeå universitet,Urologi och andrologi
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- Bex, Axel (författare)
- Netherlands Cancer Institute
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(creator_code:org_t)
- Elsevier, 2019
- 2019
- Engelska.
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Ingår i: European Urology Focus. - : Elsevier. - 2405-4569. ; :5, s. 857-866
- Relaterad länk:
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https://www.reposito...
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http://dx.doi.org/10...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://lup.lub.lu.s...
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Abstract
Ämnesord
Stäng
- BACKGROUND: Optimal follow-up (FU) strategy to detect potentially curable (PC) recurrences after treatment of localised clear cell renal cell carcinoma (ccRCC) is unclear. This study retrospectively analysed a large international database to determine recurrence patterns and overall survival (OS), as part of a wider project to issue recommendations on FU protocols.OBJECTIVE: To analyse associations between RCC recurrences in patients with ccRCC, their risk group stratifications, treatments, and subsequent outcomes.DESIGN, SETTING, AND PARTICIPANTS: Nonmetastatic ccRCC patients treated with curative intent between 1 January 2006 and 31 December 2011, with at least 4 yr of FU, were included. Patient, tumour and recurrence characteristics, Leibovich score, and management and survival data were recorded. Isolated local, solitary, and oligometastatic (three or fewer lesions at a single site) recurrences were considered PC, while all others were probably incurable (PI).INTERVENTION: Primarily curative surgical treatment of ccRCC while at recurrence detection metastasectomy, systemic therapy, best supportive care, or observation.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Incidence, time to recurrence (TTR), and OS were measured. Competing risk analysis, Kaplan-Meier, and Cox regression models were used.RESULTS AND LIMITATION: Of 1265 patients with ccRCC, 286 had a recurrence, with 131 being PC and 155 PI. Five-year cumulative risks of recurrence for low- (n=53), intermediate- (n=105), and high-risk (n=128) patients were, respectively, 7.2%, 23.2%, and 61.6%, of whom 52.8%, 37.1%, and 30.5% were PC, respectively. Median TTR was 25.0 for PC patients versus 17.3 mo for PI patients (p=0.004). Median OS was longer in PC compared with that in PI patients (p<0.001). Competing risk analysis showed highest risk of ccRCC-related death in younger and high-risk patients. Limitations were no data on comorbidities, retrospective cohort, and insufficient data excluding 12% of cohort.CONCLUSIONS: Low-risk group recurrences are rare and develop later. Treatment of recurrences with curative intent is disappointing, especially in high-risk patients. An age- and risk score-dependent FU approach is suggested.PATIENT SUMMARY: We analysed data from eight European countries, and found that the incidence of the kidney cancer recurrence and patient survival correlated with clinical factors known to predict cancer recurrence reliably and age. We conclude that these factors should be used to design follow-up strategies.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Nyckelord
- Clear cell renal cell carcinoma
- Follow-up
- Kidney cancer
- Recurrence
- Surveillance
- Survival
- Clear cell renal cell carcinoma
- Follow-up
- Kidney cancer
- Recurrence
- Surveillance
- Survival
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Dabestani, Saeed
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Beisland, Christ ...
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Stewart, Grant D ...
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Bensalah, Karim
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Gudmundsson, Eir ...
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Lam, Thomas B.
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Gietzmann, Willi ...
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Zakikhani, Paima ...
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Marconi, Lorenzo
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Fernandéz-Pello, ...
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Monagas, Serenel ...
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Williams, Samuel ...
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Torbrand, Christ ...
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Powles, Thomas
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Van Werkhoven, E ...
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Meijer, Richard
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Volpe, Alessandr ...
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Staehler, Michae ...
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Ljungberg, Börje ...
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Bex, Axel
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Urologi och njur ...
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European Urology ...
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Umeå universitet
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Lunds universitet