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  • Marconi, LorenzoUniversity Hospital of Coimbra (författare)

Local treatment of recurrent renal cell carcinoma may have a significant survival effect across all risk-of-recurrence groups

  • Artikel/kapitelEngelska2023

Förlag, utgivningsår, omfång ...

  • Elsevier,2023
  • electronicrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:umu-202681
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-202681URI
  • https://doi.org/10.1016/j.euros.2022.11.008DOI
  • https://lup.lub.lu.se/record/29b0e1c5-b64e-4d06-b230-b884030b2c6eURI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

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Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • BACKGROUND: Retrospective comparative studies suggest a survival benefit after complete local treatment of recurrence (LTR) in renal cell carcinoma (RCC), which may be largely due to an indication bias.OBJECTIVE: To determine the role of LTR in a homogeneous population characterised by limited and potentially resectable recurrence.DESIGN SETTING AND PARTICIPANTS: RECUR is a protocol-based multicentre European registry capturing patient and tumour characteristics, risk of recurrence (RoR), recurrence patterns, and survival of those curatively treated for nonmetastatic RCC from 2006 to 2011. Per-protocol resectable disease (RD) recurrence was defined as (1) solitary metastases, (2) oligometastases, or (3) renal fossa or renal recurrence after radical or partial nephrectomy, respectively.INTERVENTION: Local treatment of recurrence.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Overall survival (OS) and cancer-specific survival was compared in the RD population that underwent LTR versus no LTR. We constructed a multivariate model to predict risk factors for overall mortality and analysed the effect of LTR across RoR groups.RESULTS AND LIMITATIONS: Of 3039 patients with localised RCC treated with curative intent, 505 presented with recurrence, including 176 with RD. Of these patients, 97 underwent LTR and 79 no LTR. Patients in the LTR group were younger (64.3 [40-80] vs 69.2 [45-87] yr; p = 0.001). The median OS was 70.3 mo (95% confidence interval [CI] 58-82.6) versus 27.4 mo (95% CI 23.6-31.15) in the LTR versus no-LTR group (p < 0.001). After a multivariate analysis, having LTR (hazard ratio [HR] 0.37 [95% CI 0.2-0.6]), having low- versus high-risk RoR (HR 0.42 [95% CI [0.20-0.83]), and not having extra-abdominal/thoracic metastasis (HR 1.96 [95% CI 1.02-3.77]) were prognostic factors of longer OS. The LTR effect on survival was consistent across risk groups. OS HR for high, intermediate, and low risks were 0.36 (0.2-0.64), 0.27 (0.11-0.65), and 0.26 (0.08-0.8), respectively. Limitations include retrospective design.CONCLUSIONS: This is the first study assessing the effectiveness of LTR in RCC in a comparable population with RD. This study supports the role of LTR across all RoR groups.PATIENT SUMMARY: We assessed the effectiveness of local treatment of resectable recurrent renal cell carcinoma after surgical treatment of the primary kidney tumour. Local treatment of recurrence was associated with longer survival across groups with a risk of recurrence.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Kuusk, TeeleRoyal London Hospital (författare)
  • Capitanio, UmbertoSan Raffaele Hospital (författare)
  • Beisland, ChristianHaukeland University Hospital,University of Bergen (författare)
  • Lam, ThomasUniversity of Aberdeen (författare)
  • Pello, Sergio FernandezUniversity Hospital Cabueñes (författare)
  • Stewart, Grant DCambridge University Hospitals NHS Foundation Trust,University of Cambridge (författare)
  • Klatte, TobiasCharité - University Medicine Berlin (författare)
  • Volpe, AlessandroUniversity of Eastern Piedmont (författare)
  • Ljungberg, Börje,Professor,1949-Umeå University,Umeå universitet,Urologi och andrologi(Swepub:umu)bolj0001 (författare)
  • Dabestani, SaeedLund University,Lunds universitet,Urologisk cancerforskning, Malmö,Forskargrupper vid Lunds universitet,Urologi,Urological cancer, Malmö,Lund University Research Groups,Urology(Swepub:lu)med-sdd (författare)
  • Bex, AxelAntoni Van Leeuwenhoek Hospital,University College London (författare)
  • University Hospital of CoimbraRoyal London Hospital (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:European Urology Open Science: Elsevier47, s. 65-722666-16912666-1683

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