title: Which Patients Should We Follow up beyond 5 Years after Definitive Therapy for Localized Renal Cell Carcinoma?
abstract: OBJECTIVE
  Up to 10% of recurrences develop beyond 5 years after curative treatment of localized renal cell carcinoma (RCC). Clinicopathologic features were evaluated to determine which factors are associated with late recurrence.
  
  
  METHODS
  A total of 753 patients were diagnosed with localized RCC from January 2000 to June 2008. We enrolled 225 patients who were treated surgically and had a minimal recurrence-free survival of 60 months. Patients who had recurrence beyond 5 years after nephrectomy were defined as the late recurrence group and the remaining patients as the recurrence-free group. Multivariate logistic regression analyses and the Cox proportional hazard model were used for determination of features associated with late recurrence.
  
  
  RESULTS
  In multivariate analyses, age older than 60 (p=0.030), Fuhrman grade ≥ 3 (p=0.042), and pT stage ≥ pT2 (p=0.010) showed statistical association with late recurrence. The Cox proportional hazard model showed significant differences in recurrence-free survival when we classified the patients based on pT2 (p=0.007) and on patient age ≥ 60 years (p=0.039).
  
  
  CONCLUSIONS
  Patient age greater than 60 years, Fuhrman grade ≥ 3, and tumor stage ≥ pT2 are independent risk factors of recurrence more than 5 years after surgery in patients with RCC. Therefore, close lifelong follow-up is recommended for patients with these risk factors.
authors.affiliation: Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Sang Hyub
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Hee Seo
authors.initials: HS
authors.lastname: Son
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Seok
authors.initials: S
authors.lastname: Cho
authors.affiliation: Department of Urology, Myongji Hospital, Goyang, Korea.
authors.forename: Sang Jin
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Urology, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Dae Seon
authors.initials: DS
authors.lastname: Yoo
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Seok Ho
authors.initials: SH
authors.lastname: Kang
authors.affiliation: Department of Urology, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Sung Yul
authors.initials: SY
authors.lastname: Park
authors.affiliation: Department of Urology, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Jinsung
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Sung-Goo
authors.initials: SG
authors.lastname: Chang
authors.affiliation: Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Seung Hyun
authors.initials: SH
authors.lastname: Jeon
keywords: Kidney; Neoplasms; Recurrence; Renal cell carcinoma