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. 2024 Jun 10;5(8):791-798.
doi: 10.1002/bco2.375. eCollection 2024 Aug.

Recurrence patterns following nephrectomy for renal cell carcinoma in a Danish nationwide cohort

Goran Bencina  1 , Rolf Billeskov  2 , Rasmine Bak  3 , Ahmed Al-Sabbagh  4 , Julie Højgaard Pedersen  4 , Marina Lunetcas  5 , Emma Heeno  6 , Sara Tolouee  7 , Tuba Ashraf  8 , Niels Fristrup  9 , Nessn Azawi  8
Affiliations

Recurrence patterns following nephrectomy for renal cell carcinoma in a Danish nationwide cohort

Goran Bencina et al. BJUI Compass. .

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] BJUI Compass. 2024 Dec 30;5(12):1324-1329. doi: 10.1002/bco2.482. eCollection 2024 Dec. BJUI Compass. 2024. PMID: 39744071 Free PMC article.

Abstract

Objectives: This study aimed to characterize the demographic and clinical features of patients with renal cell carcinoma (RCC) post-surgery for localized or locally advanced disease in a national Danish cohort, with a specific focus on describing recurrence patterns in a subgroup aligned with the adjuvant KEYNOTE-564 trial classification.

Methods: This was a retrospective analysis of the Danish Renal Cancer (DaRenCa) database. Eligible subjects were individuals with an RCC diagnosis between January 2014 and December 2017 who subsequently underwent radical or partial nephrectomy. Variables of interest were demographic and clinical characteristics, rates and sites of recurrence. Recurrence rates were also assessed in a subpopulation stratified using the risk classifications of the KEYNOTE-564 trial.

Results: A total of 2164 RCC patients were identified. Most patients (84.8%) had non-metastatic RCC (stage M0). A recurrence was observed in 250 of the M0 patients (13.6%). Patients with a recurrence were older, male, had a higher tumour stage, had undergone radical nephrectomy and had a higher Leibovich score. The majority (74.8%) of M0 patients had recurrence at distant metastatic sites. A total of 392 patients were stratified by the KEYNOTE-564 risk classification: 335 intermediate-high risk, 17 high risk and 40 M1 NED (metastatic with no evidence of disease). Recurrence was observed in 37.0%, 88.2% and 27.5% of these risk groups, respectively.

Conclusions: This study elucidates the rates and determinants of post-surgical RCC recurrence in Denmark, underscoring the potential of adjuvant immunotherapy in refining therapeutic strategies, identifying suitable beneficiaries and minimizing overtreatment risks in RCC care.

Keywords: KEYNOTE‐564 trial; carcinoma, renal cell; neoplasm metastasis; neoplasm recurrence, local; nephrectomy.

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Conflict of interest statement

Goran Bencina and Rolf Billeskov are employees of Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA, and may own stocks and/or stock options in Merck & Co., Inc. Niels Fristrup has performed educational sessions for Bristol‐Myers Squibb Company, AstraZeneca, Pfizer and Merck and Co., Inc. and has performed consultancy for Merck and Co., Inc., Eisai and Ipsen. All other authors have no conflicts of interest to report.

Figures

FIGURE 1
FIGURE 1
Kaplan–Meier plot of recurrence in the M0 cohort (n = 1835).
FIGURE 2
FIGURE 2
Recurrence in patients stratified by the KEYNOTE‐564 classification. (A) Distribution of 392 patients among the various KEYNOTE‐564 risk categories. The categories are described in detail in Section 2. (B) Rates of recurrence within each risk category. Int, intermediate; NED, no evidence of disease; RCC, renal cell carcinoma.
FIGURE 3
FIGURE 3
Kaplan–Meier plot of recurrence in the patients stratified by KEYNOTE‐564 risk classification (n = 392). The green line represents the 392 patients who fit the KEYNOTE‐564 risk criteria. The blue line represents the remaining 1443 patients who did not meet the KEYNOTE‐564 risk criteria.
FIGURE 4
FIGURE 4
Kaplan–Meier plot of recurrence in the KEYNOTE‐564 subpopulation of pT3/N0/M0 patients stratified by Fuhrman grade.
See this image and copyright information in PMC

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