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. 2025 Jul 14.
doi: 10.1007/s10147-025-02825-y. Online ahead of print.

Risk stratification for recurrence after nephrectomy in high-risk renal cell carcinoma patients

Taisuke Tobe  1 , Jun Teishima  2 , Hideto Ueki  1 , Yusuke Shiraishi  1 , Naoto Wakita  1 , Yasuyoshi Okamura  1 , Kotaro Suzuki  1 , Yukari Bando  1 , Takuto Hara  1 , Tomoaki Terakawa  1 , Koji Chiba  1 , Akihisa Yao  1 , Hideaki Miyake  1
Affiliations

Risk stratification for recurrence after nephrectomy in high-risk renal cell carcinoma patients

Taisuke Tobe et al. Int J Clin Oncol. .

Abstract

Background: To identify prognostic factors that guide adjuvant therapy decisions, we investigated factors predicting recurrence in patients with high-risk clear cell renal cell carcinoma (RCC) after nephrectomy.

Methods: We retrospectively reviewed patients with non-metastatic, high-risk clear cell RCC who underwent radical or partial nephrectomy at our institution and affiliated centers between January 2016 and March 2024. Multivariate analysis using the Cox proportional hazards model was performed to identify clinicopathological factors associated with recurrence. On the basis of these factors, we developed a risk stratification model.

Results: A total of 338 patients were included. The 5-year recurrence-free survival (RFS) rate was 54.3%. Multivariate analysis identified a body mass index of ≤ 22 kg/m2 (Hazard Ratio [HR]: 2.61), rhabdoid differentiation (HR: 5.14), anemia (HR: 1.97), hypercalcemia (HR: 2.67), and C-reactive protein ≥ 0.5 mg/dL (HR: 1.72) as independent predictors of recurrence. RFS was significantly different between patients with varying numbers of risk factors: 3-year RFS rates were 22.6% for those with 3-4 factors, 47.9% for those with two, 75.5% for those with one, and 83.6% for those with none.

Conclusion: We identified independent predictors of recurrence in patients with nephrectomy-treated clear cell RCC. Patients stratified according to a risk score based on these factors had different recurrence rates, suggesting that this score could assist in guiding adjuvant therapy decisions.

Keywords: Adjuvant therapy; Nephrectomy; Pembrolizumab; Renal cell carcinoma; Risk stratification.

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Conflict of interest statement

Declarations. Conflict of interests: All authors declare no conflicts of interest related to this study. Ethics approval: This study was approved by the Institutional Review Board of Kobe University Hospital (approval no. B240116) and was conducted in accordance with the Declaration of Helsinki.

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References

    1. Rose TL, Kim WY (2024) Renal cell carcinoma: a review. JAMA 332(12):1001–1010. https://doi.org/10.1001/jama.2024.12848 - DOI - PubMed - PMC
    1. van der Mijn JC, Al Hussein Al Awamlh B, Islam Khan A et al (2019) Validation of risk factors for recurrence of renal cell carcinoma: results from a large single-institution series. PLoS ONE 14(12):e0226285. https://doi.org/10.1371/journal.pone.0226285 - DOI - PubMed - PMC
    1. Nakajima N, Miyajima A, Shinohara N et al (2022) Risk factors for recurrence after operation in patients with pT1a renal cell carcinoma: sub-analysis of the multi-institutional national database of the Japanese Urological Association. Jpn J Clin Oncol 52(3):274–280. https://doi.org/10.1093/jjco/hyab201 - DOI - PubMed
    1. Marconi L, Sun M, Beisland C et al (2021) Prevalence, disease-free, and overall survival of contemporary patients with renal cell carcinoma eligible for adjuvant checkpoint inhibitor trials. Clin Genitourin Cancer 19(2):e92–e99. https://doi.org/10.1016/j.clgc.2020.12.005 - DOI - PubMed
    1. Ishiyama Y, Kondo T, Ishihara H et al (2022) C-reactive protein kinetics to predict recurrence of high-risk renal cell carcinoma after radical surgery. Int J Clin Oncol 27(5):969–976. https://doi.org/10.1007/s10147-022-02136-6 - DOI - PubMed

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