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Surgical Management and Oncologic Outcomes for Local Retroperitoneal Recurrence of Renal Cell Carcinoma After Radical Nephrectomy.
Huang, Jiwei; Wang, Yueming; Zhang, Cuijian; Hu, Xiaoyi; Wang, Ping; Shi, Guohai; Dong, Liang; Zhang, Jin; Kong, Wen; Chen, Yonghui; Xia, Dan; Guo, Jianming; Xue, Wei; Huang, Yiran; He, Zhisong.
Afiliação
  • Huang J; Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P. R. China. Electronic address: huangjiwei@renji.com.
  • Wang Y; Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P. R. China.
  • Zhang C; Department of Urology, First Hospital of Peking University, Beijing, P. R. China.
  • Hu X; Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China.
  • Wang P; Department of Urology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, P. R. China.
  • Shi G; Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, P. R. China.
  • Dong L; Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P. R. China.
  • Zhang J; Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P. R. China.
  • Kong W; Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P. R. China.
  • Chen Y; Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P. R. China.
  • Xia D; Department of Urology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, P. R. China. Electronic address: 1194059@zju.edu.cn.
  • Guo J; Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China. Electronic address: guo.jianming@zs-hospital.sh.cn.
  • Xue W; Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P. R. China. Electronic address: xuewei@renji.com.
  • Huang Y; Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P. R. China. Electronic address: yrhuangrenji@163.com.
  • He Z; Department of Urology, First Hospital of Peking University, Beijing, P. R. China. Electronic address: wyj7074@sohu.com.
Clin Genitourin Cancer ; 21(2): 315.e1-315.e7, 2023 04.
Article em En | MEDLINE | ID: mdl-36396584
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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Retroperitoneais / Carcinoma de Células Renais / Neoplasias Renais Tipo de estudo: Clinical_trials / Prognostic_studies Limite: Humans Idioma: En Revista: Clin Genitourin Cancer Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Retroperitoneais / Carcinoma de Células Renais / Neoplasias Renais Tipo de estudo: Clinical_trials / Prognostic_studies Limite: Humans Idioma: En Revista: Clin Genitourin Cancer Ano de publicação: 2023 Tipo de documento: Article