Time to recurrence is a significant predictor of cancer-specific survival after recurrence in patients with recurrent renal cell carcinoma - Results from a comprehensive multi-centre database (CORONA/SATURN-Project)

Sabine D. Brookman-May, Matthias May, Shahrokh F. Shariat, Giacomo Novara, Richard Zigeuner, Luca Cindolo, Ottavio De Cobelli, Cosimo De Nunzio, Sascha Pahernik, Manfred P. Wirth, Nicola Longo, Alchiede Simonato, Sergio Serni, Salvatore Siracusano, Alessandro Volpe, Giuseppe Morgia, Roberto Bertini, Orietta Dalpiaz, Christian Stief, Vincenzo Ficarra

Research output: Contribution to journalArticle

Abstract

Objectives To assess the prognostic impact of time to recurrence (TTR) on cancer-specific survival (CSS) after recurrence in patients with renal cell carcinoma (RCC) undergoing radical nephrectomy or nephron-sparing surgery. To analyse differences in clinical and histopathological criteria between patients with early and late recurrence. Patients and Methods Of 13 107 patients with RCC from an international multicentre database, 1712 patients developed recurrence in the follow-up (FU), at a median (interquartile range) of 50.1 (25-106) months. In all, 1402 patients had recurrence at ≤5 years (Group A) and 310 patients beyond this time (Group B). Differences in clinical and histopathological variables between patients with early and late recurrence were analysed. The influence of TTR and further variables on CSS after recurrence was assessed by Cox regression analysis. Results Male gender, advanced age, tumour diameter and stage, Fuhrman grade 3-4, lymphovascular invasion (LVI), and pN + stage were significantly more frequent in patients with early recurrence, who had a significantly reduced 3-year CSS of 30% compared with patients in Group B (41%; P = 0.001). Age, gender, tumour histology, pT stage, and continuous TTR (hazard ratio 0.99, P = 0.006; monthly interval) independently predicted CSS. By inclusion of dichotomised TTR in the multivariable model, a significant influence of this variable on CSS was present until 48 months after surgery, but not beyond this time. Conclusions Advanced age, male gender, larger tumour diameters, LVI, Fuhrman grade 3-4, pN + stage, and advanced tumour stages are associated with early recurrence. Up to 4 years from surgery, a shorter TTR independently predicts a reduced CSS after recurrence.

Original languageEnglish
Pages (from-to)909-916
Number of pages8
JournalBJU International
Volume112
Issue number7
DOIs
Publication statusPublished - Nov 2013

Keywords

  • cancer-specific survival
  • early recurrence
  • late recurrence
  • nephrectomy
  • prognostic parameters
  • renal cell carcinoma (RCC)
  • time to recurrence

ASJC Scopus subject areas

  • Urology

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  • Cite this

    Brookman-May, S. D., May, M., Shariat, S. F., Novara, G., Zigeuner, R., Cindolo, L., De Cobelli, O., De Nunzio, C., Pahernik, S., Wirth, M. P., Longo, N., Simonato, A., Serni, S., Siracusano, S., Volpe, A., Morgia, G., Bertini, R., Dalpiaz, O., Stief, C., & Ficarra, V. (2013). Time to recurrence is a significant predictor of cancer-specific survival after recurrence in patients with recurrent renal cell carcinoma - Results from a comprehensive multi-centre database (CORONA/SATURN-Project). BJU International, 112(7), 909-916. https://doi.org/10.1111/bju.12246