title: Renal cell carcinoma: analysis of postoperative recurrence patterns.
abstract: OBJECTIVE
  To retrospectively analyze the recurrence patterns of renal cell carcinoma (RCC) and the factors affecting tumor recurrence.
  
  
  METHODS
  The institutional review board approved this study; patient informed consent was not required. There were 162 men (mean age, 54 years +/- 13 [standard deviation]) and 32 women (mean age, 56 years +/- 11) who had undergone complete surgical resection of RCC. Mean follow-up period was 45 months (range, 7-92 months). In consensus, two radiologists determined the presence or absence of tumor recurrence and recorded the time and sites of tumor recurrence. The relationships between tumor recurrence and tumor factors, including greatest diameter (> or =5 cm or <5 cm), T stage, N stage, stage group, histologic subtype, and nuclear grade, were evaluated by using Kaplan-Meier statistics.
  
  
  RESULTS
  Tumor recurred in 41 (21%) patients. The mean time of tumor recurrence was 17 months (range, 3-50 months). Tumor recurred within 2 years after surgery in 34 (83%) patients. Tumor recurrence sites included lung (n = 29), bone (n = 13), the nephrectomy site (n = 7), brain (n = 6), liver (n = 5), mediastinal lymph nodes (n = 5), the contralateral kidney (n = 4), and the neck muscles (n = 2). The recurrence rate was greater for tumors 5 cm or larger than for those smaller than 5 cm, greater for T3a or T3b tumors than for T1 tumors, greater for stage III tumors than for stage I tumors, and greater for tumors with a nuclear grade of 3 or 4 than for those with a nuclear grade of 1 or 2 (P < .05 for all).
  
  
  CONCLUSIONS
  RCC usually recurs within 2 years after surgery, with the lung being the most vulnerable site; greatest tumor diameter, T stage, stage group, and nuclear grade are important factors for recurrence.
authors.affiliation: Department of Radiology, Asan Medical Center, University of Ulsan, 388-1 Poongnap-dong, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Eun Jin
authors.initials: EJ
authors.lastname: Chae
authors.forename: Jeong Kon
authors.initials: JK
authors.lastname: Kim
authors.forename: Soo Hyun
authors.initials: SH
authors.lastname: Kim
authors.forename: Sang-Jin
authors.initials: SJ
authors.lastname: Bae
authors.forename: Kyoung-Sik
authors.initials: KS
authors.lastname: Cho
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D009367:Neoplasm Staging; D009392:Nephrectomy; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed