MP41-19 LOCAL RECURRENCE AFTER PARTIAL NEPHRECTOMY FOR PRIMARY RENAL TUMORS – INCIDENCE, RISK FACTORS AND ONCOLOGIC FOLLOW-UP

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy I1 Apr 2016MP41-19 LOCAL RECURRENCE AFTER PARTIAL NEPHRECTOMY FOR PRIMARY RENAL TUMORS – INCIDENCE, RISK FACTORS AND ONCOLOGIC FOLLOW-UP Asaf Shvero, Dorit Zilberman, Yoram Mor, Issac Kaver, Edi Fridman, Orith Portnoy, Menahem Laufer, Raanan Berger, Jacob Ramon, and Zohar Dotan Asaf ShveroAsaf Shvero More articles by this author , Dorit ZilbermanDorit Zilberman More articles by this author , Yoram MorYoram Mor More articles by this author , Issac KaverIssac Kaver More articles by this author , Edi FridmanEdi Fridman More articles by this author , Orith PortnoyOrith Portnoy More articles by this author , Menahem LauferMenahem Laufer More articles by this author , Raanan BergerRaanan Berger More articles by this author , Jacob RamonJacob Ramon More articles by this author , and Zohar DotanZohar Dotan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.186AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Partial nephrectomy is the treatment of choice for small renal tumors. One of the risks of partial nephrectomy is local recurrence at the surgery site. The purpose of this study was to check the rate of local recurrence after partial nephrectomy for primary renal tumors, to determine the risk factors for local recurrence, and to examine the oncologic outcome in cases of local recurrence. METHODS In our database of patients who underwent nephrectomy between 1987-2014 there are 2015 patients. 832 patients underwent partial nephrectomy for primary renal tumors. Patients with final pathology other than renal cell carcinoma were excluded from the study. 692 patients met the inclusion criteria. Local recurrence defined as recurrence of the tumor in the original resection area or at the ipsilateral kidney bed. In this study we analyzed the relation between demographic data (gender, age, year of surgery), and pathological data (tumor size, histological type, stage and grade, positive surgical margin), with oncologic results. The study was approved by the local ethics committee. RESULTS The median age at the time of surgery was 62 years (inter-quartile range 53-70), 67% were men. The average tumor size (±standard deviation) was 3.3cm (±1.4), in a range of 1-8cm. Local recurrence was found in 20 patients (2.8%) at an average of 31.5 (±26.6) months after surgery. Among these, renal local recurrence was found in 18 (90%) patients, peri-renal in 5 (25%), and in 3 patients (15%) a combined recurrence. 16 (80%) and 3 (15%) of the patients with local recurrence were treated with radical and partial nephrectomy respectively. The last patient was treated medically only. Moreover, among these 20 patients, in 6 patients a metastatic progression was found. In 3 patients at the time of local recurrence and in 3 patients after 24-45 months after the local recurrence. Local recurrence was not significantly related to positive surgical margins (p=0.10), histological type (p=0.26), Age (p=0.88), and gender (p=0.41), but was significantly related to the tumor stage (p=0.001) and grade (p<0.001). Metastatic progression and tumor related death rates were significantly higher in the group of patients with local recurrence (p<0.001, p<0.001, respectively). CONCLUSIONS The incidence of local recurrence after partial nephrectomy for primary renal tumors is very low and was associated with tumor stage and grade. All the patients beside one, were treated surgically for the local recurrence. Local recurrence is associated with increased rates of metastatic progression and death of disease. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e567-e568 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Asaf Shvero More articles by this author Dorit Zilberman More articles by this author Yoram Mor More articles by this author Issac Kaver More articles by this author Edi Fridman More articles by this author Orith Portnoy More articles by this author Menahem Laufer More articles by this author Raanan Berger More articles by this author Jacob Ramon More articles by this author Zohar Dotan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...