title: Is Late Recurrence a Predictive Clinical Marker for Better Sunitinib Response in Metastatic Renal Cell Carcinoma Patients?
abstract: BACKGROUND
  We investigated the clinicopathological features in patients with recurrent renal cell carcinoma (RCC) within 5 years or more than 5 years after nephrectomy and determined predictors of overall survival (OS) and progression-free survival (PFS) after disease recurrence in the administration of first-line sunitinib in the treatment of metastatic RCC (mRCC).
  
  
  METHODS
  In this study we enrolled 86 Turkish patients with mRCC who received sunitinib. Univariate analyses were performed using the log rank test.
  
  
  RESULTS
  Fifty-six patients (65%) were diagnosed with disease recurrence within 5 years after radical nephrectomy (early recurrence) and 30 patients (35%) were diagnosed with recurrence more than 5 years after radical nephrectomy (late recurrence). Fuhrman grade was statistically significantly different between the 2 groups (P = .013). The late recurrence patients were significantly associated with the Memorial Sloan Kettering Cancer Center favorable risk group compared with patients with early recurrence (P = .001). There was a statistically significant correlation between recurrence time and the rate of objective remission (ORR) (the late recurrence group vs. the early recurrence group: 43.3% vs. 14.3%, respectively; P = .004). From the time of disease recurrence, the median OS was 42.0 (95% confidence interval [CI], 24.4-59.5) months in the late recurrence group, and 16 (95% CI, 11.5-20.4) months in the early recurrence group (P = .001). Median PFS was 8 (95% CI, 4.05-11.9) months in the early recurrence group, and 20 (95% CI, 14.8-25.1) months in the late recurrence group (P ≤ .001).
  
  
  CONCLUSIONS
  The study demonstrated a potential prognostic value of late recurrence in terms of PFS, OS, and ORR.
authors: Department of Medical Oncology, Erciyes University Faculty of Medicine, Kayseri, Turkey. Electronic address: bozkurt.oktay8@gmail.com.
authors: Oktay
authors: O
authors: Bozkurt
authors: Department of Medical Oncology, Trakya University Faculty of Medicine, Edirne, Turkey.
authors: Ilhan
authors: I
authors: Hacıbekiroglu
authors: Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakır, Turkey.
authors: Muhammet Ali
authors: MA
authors: Kaplan
authors: Department of Internal Medicine, Dicle University Faculty of Medicine, Diyarbakır, Turkey.
authors: Yakup
authors: Y
authors: Duzkopru
authors: Department of Medical Oncology, Afyon Kocatepe University Faculty of Medicine, Afyon, Turkey.
authors: Mukremin
authors: M
authors: Uysal
authors: Department of Medical Oncology, Erciyes University Faculty of Medicine, Kayseri, Turkey.
authors: Halit
authors: H
authors: Karaca
authors: Kayseri Training and Research Hospital Medical Oncology Department, Kayseri, Turkey.
authors: Veli
authors: V
authors: Berk
authors: Kayseri Training and Research Hospital Medical Oncology Department, Kayseri, Turkey.
authors: Mevlude
authors: M
authors: Inanc
authors: Department of Medical Oncology, Erciyes University Faculty of Medicine, Kayseri, Turkey.
authors: Ayse Ocak
authors: AO
authors: Duran
authors: Department of Medical Oncology, Erciyes University Faculty of Medicine, Kayseri, Turkey.
authors: Ersin
authors: E
authors: Ozaslan
authors: Department of Medical Oncology, Erciyes University Faculty of Medicine, Kayseri, Turkey.
authors: Mahmut
authors: M
authors: Ucar
authors: Department of Medical Oncology, Erciyes University Faculty of Medicine, Kayseri, Turkey.
authors: Metin
authors: M
authors: Ozkan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D007211:Indoles / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D011379:Prognosis; D011758:Pyrroles / Q000627:therapeutic use*; D000077210:Sunitinib; D016019:Survival Analysis; D016896:Treatment Outcome; D014421:Turkey
chemical_list: D000970:Antineoplastic Agents; D007211:Indoles; D011758:Pyrroles; D000077210:Sunitinib
keywords: Late recurrence; Prognostic factor; Renal cell carcinoma; Sunitinib; Survival