title: Time to recurrence after nephrectomy as a predictor of cancer-specific survival in localized clear-cell renal cell carcinoma.
abstract: OBJECTIVE
  To evaluate the prognostic impact of early recurrence (within 12 months) after surgery on cancer-specific survival (CSS) of patients with localized clear-cell renal cell carcinoma (ccRCC).
  
  
  METHODS
  Patients with surgically treated localized ccRCC were studied. Using the Kaplan-Meier method, we calculated CSS; by univariate and multivariate models we analyzed the association of early recurrence with cancer-related mortality.
  
  
  RESULTS
  We identified 259 patients with pT1-4/NX/0M0 ccRCC treated between February 1981 and September 2009; of 66 (25.5%) with disease recurrence, 29 (43.9%) had early relapse. Overall, 43 patients (16.6%) died from ccRCC. The 5- and 10-year CSS for those without, late and early recurrence was 98.5 and 96.5%, 53 and 39.8%, and 23 and 23%, respectively (p < 0.0001). In the multivariate Cox model, pT stage (p = 0.01) and early recurrence (p < 0.0001) independently predicted CSS.
  
  
  CONCLUSIONS
  Recurrent disease after localized ccRCC confers a poor prognosis, especially if detected within 12 months after surgery. Thus, this criterion should be included as an independent risk factor for cancer-related mortality.
authors.affiliation: Department of Urology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico. frodriguez.covarrubias@gmail.com
authors.forename: Francisco
authors.initials: F
authors.lastname: Rodriguez-Covarrubias
authors.forename: M Olivia
authors.initials: MO
authors.lastname: Gomez-Alvarado
authors.forename: Mariano
authors.initials: M
authors.lastname: Sotomayor
authors.forename: Ricardo
authors.initials: R
authors.lastname: Castillejos-Molina
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Mendez-Probst
authors.forename: Fernando
authors.initials: F
authors.lastname: Gabilondo
authors.forename: Guillermo
authors.initials: G
authors.lastname: Feria-Bernal
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D009392:Nephrectomy; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors