Abstract
Introduction
Local retroperitoneal recurrence (RPR) after racial nephrectomy (RN) of renal cell
carcinoma (RCC) remains a therapeutic challenge and has a poor prognosis. We aimed
to compare the oncological outcomes of patients with RPR treated with RPR surgery
or targeted therapy alone and assess the prognostic factors of these patients.
Patients and Methods
This is a retrospective multi-center study of patients with RPR after prior RN treated
with or without surgical treatment from 2008 to 2020. RPR of RCC is defined as an
ipsilateral recurrence confined to the renal fossa, adrenal gland or retroperitoneal
lymph nodes after prior nephrectomy, which was diagnosed by cross-sectional imaging.
Clinical and pathological features, perioperative complications were reported using
descriptive statistics. Cancer-specific survival (CSS) was evaluated by Kaplan-Meier
method and studied using Cox proportional hazards model.
Results
Median follow-up period was 35 months (IQR 20-61) for the RPR surgery group and 23
months (IQR 9-40.5) for the targeted therapy group. No patients had distant metastatic
disease at the time of RPR diagnosis. Treatment with RPR surgery resulted in significantly
longer CSS than targeted therapy alone (P < .001). In multivariable analysis, high Fuhrman grade, size of RPR tumor, mixed
type of RPR, multiple recurrence lesions and the absence of RPR surgery were associated
with a significantly increased risk of death from RCC.
Conclusion
Aggressive surgical resection of RPR after RN represents a potentially curative treatment
for selected RCC patients without synchronous metastases, resulting in significantly
longer CSS than targeted therapy alone.
Keyword
Abbreviations:
RPR (Retroperitoneal recurrence), RN (Radical nephrectomy), RCC (Renal cell carcinoma), CSS (Cancer-specific survival), RFS (Recurrence free survival)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: October 26, 2022
Accepted:
October 16,
2022
Received in revised form:
October 14,
2022
Received:
August 11,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
