MP16-15 NATURAL HISTORY OF SURGICALLY TREATED LOCAL RECURRENCE AFTER NEPHRECTOMY

Abstract

You have accessJournal of UrologyKidney Cancer: Advanced (including Drug Therapy) II1 Apr 2017MP16-15 NATURAL HISTORY OF SURGICALLY TREATED LOCAL RECURRENCE AFTER NEPHRECTOMY Paolo Capogrosso, Eric Barret, Igor Nunes-Silva, Rafael Sanchez-Salas, François Rozet, Alessandro Larcher, Ettore Di Trapani, Alberto Briganti, Andrea Salonia, Francesco Montorsi, Roberto Bertini, Umberto Capitanio, and Xavier Cathelineau Paolo CapogrossoPaolo Capogrosso More articles by this author , Eric BarretEric Barret More articles by this author , Igor Nunes-SilvaIgor Nunes-Silva More articles by this author , Rafael Sanchez-SalasRafael Sanchez-Salas More articles by this author , François RozetFrançois Rozet More articles by this author , Alessandro LarcherAlessandro Larcher More articles by this author , Ettore Di TrapaniEttore Di Trapani More articles by this author , Alberto BrigantiAlberto Briganti More articles by this author , Andrea SaloniaAndrea Salonia More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , Roberto BertiniRoberto Bertini More articles by this author , Umberto CapitanioUmberto Capitanio More articles by this author , and Xavier CathelineauXavier Cathelineau More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.521AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Local recurrence (LR) without distant metastases after renal cancer (RC) treatment is relatively rare. In this context, little is known regarding the natural history after salvage surgery for LR. METHODS We conducted a retrospective analysis on a cohort of 62 consecutive patients presenting with local recurrence after primary surgical treatment for RC at two academic institutions. In 25 cases (40.3%), patients presenting concomitant visceral and/or bone metastases were excluded. LR was defined as the presence of a pathologically confirmed recurrence of RC in the soft/tissue renal fossa after radical (RN) or at the level of the resection bed after partial nephrectomy (PN), respectively. All patients were treated with the complete surgical resection of the LR. Kaplan-Meier analysis was applied to assess rates of systemic progression (SP; defined as the evidence of distant metastases during the follow-up), disease-free survival (DFS; defined as the absence of either distant or local recurrence) and cancer specific mortality (CSM) after surgical resection of LR RESULTS Overall, 37 patients had exclusive LR (59.6%). Of those, 21 (55.6%) vs. 16 (44.4%) patients were diagnosed with an LR after RN vs. PN, respectively. Median [mean (Q1-Q3)] time to LR was 18 [29.9 (8-42)] months after RN/PN. At initial treatment (PN or RN), pathologic T stage (pT) was pT1, pT2, pT3 and pT4 in 14 (38.2%) 8 (18.9%), 14 (38.2%) and 1 (2.9%) patients. Fuhrman grade resulted low (1-2) vs. high (3-4) in 21 (59.4%) vs. 16 (40.7%) patients. At LR diagnosis, 28 (75.7%) patients were treated with LR resection only, while 9 (24.3%) received also systemic targeted therapy after LR resection. At 1 and 3 years after LR surgery, SP rates were 20% and 45% vs. 7% and 23% in RN vs. PN cases, respectively. Overall, at 1, 3 and 5 years after LR surgery, DFS was 93%, 85% and 67%. CSM resulted 10%, 20% and 25%, respectively. There was no significant difference in terms of SP, DFS and CSM between patients surgically treated for LR after RN or PN (all p>0.05). CONCLUSIONS Despite a surgical treatment of LR after either PN or RN, a systemic progression can be expected. However, given the encouraging results in terms of DFS and CSM, such management could be justified in clinical practice. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e185 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Paolo Capogrosso More articles by this author Eric Barret More articles by this author Igor Nunes-Silva More articles by this author Rafael Sanchez-Salas More articles by this author François Rozet More articles by this author Alessandro Larcher More articles by this author Ettore Di Trapani More articles by this author Alberto Briganti More articles by this author Andrea Salonia More articles by this author Francesco Montorsi More articles by this author Roberto Bertini More articles by this author Umberto Capitanio More articles by this author Xavier Cathelineau More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...