MP57-02 PREDICTIVE FACTORS FOR RECURRENCE AFTER PARTIAL NEPHRECTOMY FOR CLINICAL T1 RENAL CELL CARCINOMA: A RETROSPECTIVE STUDY OF 1568 CASES FROM A SINGLE INSTITUTION

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV (MP57)1 Apr 2020MP57-02 PREDICTIVE FACTORS FOR RECURRENCE AFTER PARTIAL NEPHRECTOMY FOR CLINICAL T1 RENAL CELL CARCINOMA: A RETROSPECTIVE STUDY OF 1568 CASES FROM A SINGLE INSTITUTION Kazuhiko Yoshida*, Toshio Takagi, Arisa Ebinuma, Tsunenori Kondo, Hironori Fukuda, Hiroki Ishihara, Hirohito Kobayashi, Junpei iizuka, Masayoshi Okuimi, Hideki Ishida, and Kazunari Tanabe Kazuhiko Yoshida*Kazuhiko Yoshida* More articles by this author , Toshio TakagiToshio Takagi More articles by this author , Arisa EbinumaArisa Ebinuma More articles by this author , Tsunenori KondoTsunenori Kondo More articles by this author , Hironori FukudaHironori Fukuda More articles by this author , Hiroki IshiharaHiroki Ishihara More articles by this author , Hirohito KobayashiHirohito Kobayashi More articles by this author , Junpei iizukaJunpei iizuka More articles by this author , Masayoshi OkuimiMasayoshi Okuimi More articles by this author , Hideki IshidaHideki Ishida More articles by this author , and Kazunari TanabeKazunari Tanabe More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000926.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Partial nephrectomy (PN) is a standard surgical approach for T1 renal tumors. Several studies have evaluated oncological outcome after PN. Identifying the predictive factors for tumor recurrence after PN is also useful to determine patients who require careful observation after surgery. Therefore, we investigated recurrence after partial nephrectomy (PN) in patients with clinical T1 renal cell carcinoma (RCC) and analyzed predictive factors for recurrence-free survival (RFS). METHODS: Patients with clinical stage 1 RCC who underwent PN between 1990 and 2018 were included. Patients without sufficient medical records for at least 6 months or those with genetically confirmed hereditary RCCs were excluded. Finally, 1568 patients were included in the analysis. The primary outcome of this study was recurrence-free survival (RFS), which was defined as the time from surgery to the date of recurrence. Recurrence included distant metastasis and local recurrence. Local recurrence was defined as tumor recurrence at the resected bed. RESULTS: The median patient age was 59 years, and the median tumor size was 30 mm. Although 1202 (77%) and 366 (23%) patients had clinical T1a and T1b RCCs, respectively, 21 patients (1.3%) were upstaged to pathological T3a. A positive surgical margin was found in 22 (1.4%) patients. The distribution of surgical approaches was open surgery in 656 (42%) patients and minimally invasive surgery in 912 (58%) patients. With a median follow-up of 30 months, 55 (3.5%) patients, including 17 with local recurrence, 13 with recurrence in the ipsilateral kidney, and 35 with distant metastasis, developed recurrence. Five-year RFS was 95%, and the median recurrence time from PN was 31 months. Multivariate analysis identified high grade tumor, multifocal tumors, and upstaging to pT3a as significant predictors for worse RFS (table). CONCLUSIONS: Patients with high grade tumors, multifocal tumors, and tumors upstaged to pT3 had a high risk of worse RFS, which suggested that careful monitoring is required for such patients after PN, even if a good prognosis is achieved in patients with clinical T1 RCC. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e857-e858 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kazuhiko Yoshida* More articles by this author Toshio Takagi More articles by this author Arisa Ebinuma More articles by this author Tsunenori Kondo More articles by this author Hironori Fukuda More articles by this author Hiroki Ishihara More articles by this author Hirohito Kobayashi More articles by this author Junpei iizuka More articles by this author Masayoshi Okuimi More articles by this author Hideki Ishida More articles by this author Kazunari Tanabe More articles by this author Expand All Advertisement PDF downloadLoading ...