title: Clinicopathological characteristics and prognosis of patients according to recurrence time after radical nephrectomy for localized renal cell carcinoma: a multicenter study of Anatolian Society of Medical Oncology (ASMO).
abstract: OBJECTIVE
  We investigated the clinicopathological features in patients with recurrent RCC within 5 years or more than 5 years after nephrectomy and determined predictors of survival and response treatment after recurrence.
  
  
  METHODS
  We retrospectively evaluated 144 patients with disease recurrence; 73 had recurrence more than 5 years after radical nephrectomy. We compared clinicopathological characteristics in patients with disease recurrence before vs. after 5 years. In addition, we investigated predictors of survival and response to treatment after recurrence.
  
  
  RESULTS
  Seventy-one patients (49%) were diagnosed with recurrence within 5 years after radical nephrectomy (early recurrence) and 73 patients (51%) were diagnosed with recurrence more than 5 years after radical nephrectomy (late recurrence). Fuhrman grade, tumor necrosis and lymphovascular invasion were statistically significantly different between the two groups (p<0.001, p=0.013, p=0.026, respectively). The late recurrence patients were significantly associated with the Memorial Sloan Kettering Cancer Center (MSKCC) favorable risk group compared to patients with early recurrence (p=0.001). From the time of disease recurrence, median Overall Survival (OS) was 36.0 (95% Confidence Interval (CI) 30.7-41.2) months in the late recurrence group, and 19 (95% CI 15.4-22.5) months in the early recurrence group (p=0.01). The median Progression Free Survival (PFS) was 6 (95% CI 3.87-8.12) months in the early recurrence group, and 18 (95% CI 15.4-20.5) months for the late recurrence group (p<0.001).
  
  
  CONCLUSIONS
  Early recurrence was significantly associated with Fuhrman grade 3-4, tumor necrosis, lymphovascular invasion, MSKCC poor-risk group compared to patients with late recurrence. The study also demonstrated a potential prognostic value of late recurrence in terms of PFS and OS.
authors: Department of Medical Oncology, Erciyes University Faculty of Medicine, Kayseri, Turkey bozkurt.oktay8@gmail.com.
authors: Oktay
authors: O
authors: Bozkurt
authors: Department of Medical Oncology, Erciyes University Faculty of Medicine, Kayseri, Turkey.
authors: Mevlüde
authors: M
authors: Inanc
authors: Department of Medical Oncology, Trakya University Faculty of Medicine, Trakya, Turkey.
authors: Ilhan
authors: I
authors: Hacibekıroglu
authors: Ankara Oncology Research and Training Hospital, Ankara, Turkey.
authors: Onur
authors: O
authors: Esbah
authors: Department of Medical Oncology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.
authors: Metın
authors: M
authors: Seker
authors: Ankara Atatürk Research and Teaching Hospital, Ankara, Turkey.
authors: Arıfe
authors: A
authors: Ulas
authors: Dr. Lutfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey.
authors: Kübra
authors: K
authors: Aydin
authors: Department of Medical Oncology, Afyon Kocatepe University Faculty of Medicine, Afyon, Turkey.
authors: Mükremın
authors: M
authors: Uysal
authors: Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakir, Turkey.
authors: Mehmet
authors: M
authors: Kücüköner
authors: Ankara Numune Research and Teaching Hospital, Ankara, Turkey.
authors: Dogan
authors: D
authors: Uncu
authors: Department of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey.
authors: Aydin
authors: A
authors: Cıltas
authors: Department of Medical Oncology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey.
authors: Olcun Ümıt
authors: OÜ
authors: Unal
authors: Ankara Oncology Research and Training Hospital, Ankara, Turkey.
authors: Ayse
authors: A
authors: Durnali
authors: Ankara Atatürk Research and Teaching Hospital, Ankara, Turkey.
authors: Umut
authors: U
authors: Demırcı
authors: Elazığ Research and Teaching Hospital, Elazığ, Turkey.
authors: Velı
authors: V
authors: Berk
authors: Department of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey.
authors: Onder
authors: O
authors: Tonyali
authors: Department of Medical Oncology, Trakya University Faculty of Medicine, Trakya, Turkey.
authors: Berna
authors: B
authors: Oksüzoglu
authors: Department of Medical Oncology, Erciyes University Faculty of Medicine, Kayseri, Turkey.
authors: Halıt
authors: H
authors: Karaca
authors: Department of Medical Oncology, Erciyes University Faculty of Medicine, Kayseri, Turkey.
authors: Metın
authors: M
authors: Ozkan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; 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; D009336:Necrosis; D009364:Neoplasm Recurrence, Local; D009392:Nephrectomy; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors
keywords: Predictive and prognostic factors; late recurrence; renal cell carcinoma