title: Recurrence of renal cell carcinoma more than 5 years after nephrectomy.
abstract: OBJECTIVE
  We evaluated clinical features and predictive factors for the recurrence of renal cell carcinoma (RCC) developing more than 5 years after nephrectomy.
  
  
  METHODS
  We retrospectively reviewed 239 patients with RCC who underwent surgery for the primary lesion. To identify factors that affected recurrence more than 5 years after nephrectomy (delayed recurrence) and its clinical outcomes, we performed a multivariate analysis using Cox's proportional hazards model and a survival study.
  
  
  RESULTS
  Recurrence developing within 5 years after nephrectomy (early recurrence) was found in 57 patients and delayed recurrence in 11 patients. The multivariate analysis revealed no clinical and pathologic features influencing delayed recurrence in 114 patients who survived more than 5 years after nephrectomy without having early recurrence. The patients with delayed recurrence showed better clinical outcomes than those with early recurrence when the rate was determined from the time of recurrence.
  
  
  CONCLUSIONS
  Although delayed recurrence is not a rare event for patients with RCC, no clinical and pathologic factors at the time of the initial treatment can predict the recurrence. Patients who are free of recurrence for more than 5 years after surgery for a primary lesion should be carefully followed up for delayed recurrence.
authors.affiliation: Department of Urology (Clinical Pathology Division), Sapporo Medical University School of Medicine, Japan.
authors.forename: Kohsuke
authors.initials: K
authors.lastname: Uchida
authors.forename: Noriomi
authors.initials: N
authors.lastname: Miyao
authors.forename: Naoya
authors.initials: N
authors.lastname: Masumori
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takahashi
authors.forename: Toshiro
authors.initials: T
authors.lastname: Oda
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yanase
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kitamura
authors.forename: Naoki
authors.initials: N
authors.lastname: Itoh
authors.forename: Masaaki
authors.initials: M
authors.lastname: Sato
authors.forename: Taiji
authors.initials: T
authors.lastname: Tsukamoto
mesh_terms: D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009392:Nephrectomy; D012189:Retrospective Studies; D013997:Time Factors