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Review
. 2022 Sep;27(9):1467-1476.
doi: 10.1007/s10147-022-02204-x. Epub 2022 Jun 29.

A clinical investigation of recurrence and lost follow-up after renal cell carcinoma surgery: a single-center, long-term, large cohort, retrospective study

Takayuki Arai  1 , Tomokazu Sazuka  2 , Hiroaki Sato  1 , Mayuko Kato  1 , Shuhei Kamada  1 , Sota Katsura  1 , Ayako Seito  1 , Shu Miyamoto  1 , Ken Wakai  1 , Nobuyoshi Takeuchi  1 , Yusuke Imamura  1 , Shinichi Sakamoto  1 , Akira Komiya  1 , Tomohiko Ichikawa  1
Affiliations
Review

A clinical investigation of recurrence and lost follow-up after renal cell carcinoma surgery: a single-center, long-term, large cohort, retrospective study

Takayuki Arai et al. Int J Clin Oncol. 2022 Sep.

Abstract

Background: Late recurrence of renal cell carcinoma (RCC) is observed in some postoperative patients. In addition, some of these patients are lost to long-term postoperative follow-up. We reviewed the treatment results and prognosis of postoperative patients with RCC at Chiba University Hospital, with the aim of clarifying the proportion and background of patients lost to follow-up.

Methods: This retrospective study included 1176 RCC patients who underwent radical or/and partial nephrectomy. Overall survival (OS), cancer-specific survival (CSS), recurrence-free survival (RFS), and lost follow-up free survival (LFFS) were evaluated and the risk factors for LFFS identified.

Results: The median RFS for stage II and II cases was 188.3 and 104.0 months, respectively. Even in stage I, recurrence was observed in about 20% of patients 20 years after surgery. The Kaplan-Meier curve for LFFS showed a linear descent over time, with 50% of patients lost to follow-up within 25 years. Older age (≥ 62 years), histological type (clear cell RCC), and no recurrence were significant risk factors for lost follow-up.

Conclusions: Long-term follow-up is necessary after RCC surgery because late recurrence cases are not uncommon. We believe that lifelong follow-up with imaging studies is recommended for postoperative RCC patients. Early detection of recurrence in postoperative patients is a very important issue, and it may be worthwhile for improving the prognosis of postoperative patients to focus on patients lost to follow-up who may have been overlooked.

Keywords: Lost follow-up free survival; Nephrectomy; Postoperative; Recurrence; Renal cell carcinoma.

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