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KMID : 0939920150470030489
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대한암학회지
2015 Volume.47 No. 3 p.489 ~ p.494
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Which Patients Should We Follow up beyond 5 Years after Definitive Therapy for Localized Renal Cell Carcinoma?
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Lee Sang-Hyub
Son Hee-Seo
Cho Seok
Kim Sang-Jin
Yoo Dae-Seon
Kang Seok-Ho
Park Sung-Yul
Park Jin-Sung
Chang Sung-Goo
Jeon Seung-Hyun
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Abstract
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Purpose: Up to 10% of recurrences develop beyond 5 years after curative treatment of localized renal cell carcinoma (RCC). Clinicopathologic features were evaluated to determine which factors are associated with late recurrence.
Materials and Methods: A total of 753 patients were diagnosed with localized RCC from January 2000 to June 2008. We enrolled 225 patients who were treated surgically and had a minimal recurrence-free survival of 60 months. Patients who had recurrence beyond 5 years after nephrectomy were defined as the late recurrence group and the remaining patients as the recurrence-free group. Multivariate logistic regression analyses and the Cox proportional hazard model were used for determination of features associated with late recurrence.
Results: In multivariate analyses, age older than 60 (p=0.030), Fuhrman grade ≥ 3 (p=0.042), and pT stage ≥ pT2 (p=0.010) showed statistical association with late recurrence. The Cox proportional hazard model showed significant differences in recurrence-free survival when we classified the patients based on pT2 (p=0.007) and on patient age ≥ 60 years (p=0.039).
Conclusion: Patient age greater than 60 years, Fuhrman grade ≥ 3, and tumor stage ≥ pT2 are independent risk factors of recurrence more than 5 years after surgery in patients with RCC. Therefore, close lifelong follow-up is recommended for patients with these risk factors.
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KEYWORD
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Renal cell carcinoma, Kidney, Neoplasms, Recurrence
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