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Risk factors for locoregional relapse after radical nephrectomy
Author(s) -
Jhavar Sameer,
Swanson Gregory,
Pruszynski Jessica
Publication year - 2018
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.12684
Subject(s) - medicine , nephrectomy , interquartile range , renal cell carcinoma , proportional hazards model , stage (stratigraphy) , adipose capsule of kidney , urology , t stage , surgical margin , univariate analysis , adjuvant therapy , multivariate analysis , surgery , oncology , cancer , kidney , paleontology , biology
Abstract Aim To identify risk factors for locoregional relapse after radical nephrectomy for renal cell carcinoma. Methods We retrospectively reviewed the charts of 259 patients who underwent radical nephrectomy for sporadic clinically localized unilateral renal cell carcinoma between 1998 and 2012. Relapse patterns (locoregional and/or distant) were identified. Relapse‐free survival was calculated using Kaplan–Meier method. Factors associated with decreased relapse‐free survival were identified using univariate and multivariate Cox proportional hazards regression model analysis. Locoregional relapse estimates were calculated for individual factors and combination of factors. Results At a median follow‐up of 68 months (interquartile range: 75 months), 24% patients relapsed. Of these, 54% had locoregional relapse. High‐grade, positive margin, large tumor size and stage III/IV were associated with worse relapse‐free survival on multivariate analysis. Locoregional relapse occurred among patients with tumor size >7–10 cm (35%), stage III/IV (31%), grade III/IV (26%), renal vein invasion (22%), perinephric fat invasion (30%), 7 cm plus grade I/II (21%), >7 cm plus grade III/IV (48%), stage III/IV plus grade I/II (24%) and stage III/IV plus grade III/IV (45%). Conclusion We were able to discern risk factors (individual or in combination) associated with increased risk of locoregional relapse after radical nephrectomy for renal cell carcinoma. This could help distinguish patients who may benefit from adjuvant locoregionally directed therapy.