title: Factors affecting the time to recurrence after radical nephrectomy for localized renal cell carcinoma.
abstract: OBJECTIVE
  The objective of this study was to determine the factors affecting the time to recurrence after radical nephrectomy for localized renal cell carcinoma.
  
  
  METHODS
  We retrospectively evaluated 321 patients who received radical nephrectomies for localized renal cell carcinoma (pT1a-pT2b N0M0). Of 29 patients with disease recurrence, 9 had recurrence more than 5 years after radical nephrectomy. We evaluated the clinicopathological factors, with the use of a retrospective study design.
  
  
  RESULTS
  Tumor necrosis was statistically different between the late recurrence group and the recurrence free group (Fisher exact test, p=0.046). Hematuria at diagnosis (chi-square test, p=0.045) was statistically significant in early recurrence. In the univariate logistic regression analysis, tumor necrosis (odds ratio [OR], 4.629; 95% confidence interval [CI], 1.106 to 19.379; p=0.036) and pT stage>1 (OR, 7.232; 95% CI, 1.727 to 30.280; p=0.007) were risk factors of late recurrence. In the multivariable logistic regression analysis, pT stage>1 (OR, 7.143; 5% CI 1.706 to 29.912, p=0.007) was associated with late recurrence. Regarding early recurrence, initial symptoms at diagnosis and pathologic T stage>1 were statistically significant in both univariate and multivariable logistic regression analysis. In terms of recurrence site, patients with late recurrence tended to have unusual metastasis sites other than lung, liver or bone (chi-square test, p=0.012).
  
  
  CONCLUSIONS
  These data suggest that tumor necrosis may affect late disease recurrence. Patients with initial symptoms and hematuria at diagnosis are vulnerable to recurrence in a shorter period after nephrectomy. Patients with late recurrence showed a tendency to have unusual metastasis site other than lung, liver or bone.
authors.affiliation: Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Hee-Seo
authors.initials: HS
authors.lastname: Son
authors.forename: Seung Hyun
authors.initials: SH
authors.lastname: Jeon
authors.forename: Sung-Goo
authors.initials: SG
authors.lastname: Chang
keywords: Disease-free survival; Recurrence; Renal cell carcinoma