Abstract
Objective
To evaluate outcomes for patients with local recurrence (LR) of clinically localized
renal cell carcinoma (RCC) without concurrent systemic metastasis from our institution,
an event that occurs rarely (1%-3%) after surgery. LR may be a harbinger of poor outcomes,
and the best management of these patients is unclear.
Materials/Methods
We retrospectively reviewed patients surgically treated for clinically localized RCC
(cT1-2N0M0) with subsequent LR (in the partial or radical nephrectomy bed) and/or
regional recurrence (RR; in the abdomen distant from the direct site of surgery) without
concurrent metastasis from our institutional database (2004-2018). Comparative and
survival analyses were performed.
Results
Out of 3038 total patients, 1895 had clinically localized RCC, with 30 patients (1.6%)
having isolated LR/RR. Median time to recurrence was 26.5 months (IQR:16-35). Of 26
patients treated with local therapy, 14 (53.8%) recurred over a median follow-up time
of 29.5 months (IQR:12-45). The 1-year and 2-year secondary recurrence-free survival
rates are 60.7% and 49.7%, respectively. Two or more sites of locoregional recurrence
significantly predicted secondary recurrence/metastasis after local therapy for local
recurrence (hazard ratio: 2.22, P= .04).
Conclusion
Our results suggest local therapy is appropriate for select patients with LR/RR, with
almost 50% of patients undergoing a second local therapy remaining alive with “local
cure” and no secondary recurrence. The number of sites of recurrence can be used to
better select patients that will benefit from local therapy or systemic/combination
therapy. This work provides a framework onto which further studies regarding local
therapy and locoregional recurrence of RCC can be performed.
Keywords
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Article info
Publication history
Published online: April 14, 2021
Accepted:
March 31,
2021
Received:
September 6,
2020
Footnotes
Author Contributions: All authors contributed to study conception, design, assembly, analysis, manuscript writing, and the final approval of the manuscript.
Conflicts of Interests: The authors have no conflicts of interest relevant to this article to disclose.
Financial Disclosures: There is no external funding for this manuscript. The authors have no financial relationships relevant to this article to disclose. No honorarium, grant, or other form of payment was given to anyone to produce the manuscript.
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