Different clinicopathological features between patients who developed early and late recurrence following surgery for renal cell carcinoma

Fujii, Yoichi; Ikeda, Masaomi; Kurosawa, Kazuhiro; Tabata, Mariko; Kamigaito, Takayuki; Hosoda, Chihiro; Okaneya, Toshikazu

doi:10.1007/s10147-014-0775-2

Cited by 16 publications

(29 citation statements)

References 31 publications

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“…The latest study on Japanese patients by Fujii et al . showed the following parameters to be independent predictive factors of ER: positive symptoms at diagnosis, ≥pT2, positive lymphovascular invasion and histological grade 3; these results were similar to those of Kobayashi et al . However, both Kroger et al .…”

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confidence: 85%

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Editorial Comment from Dr Izumi to Clinicopathological features and outcomes in patients with late recurrence of renal cell carcinoma after radical surgery

Izumi

2015

Int J of Urology

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In this issue of the International Journal of Urology, Kobayashi et al. examined the clinicopathological features, risk factors and prognosis in renal cell carcinoma (RCC) patients with late recurrence.1 As they described, one of the unique characteristics of RCC might be a biological potential for recurrence or metastasis over 5 years after primary surgical treatment with curative intent. 2,3 In the present study, 8.3% of the patients who underwent primary radical surgery and remained free of recurrence after 5 years had late recurrence of disease, which was consistent with the results in previous reports.In terms of risk factors of late recurrence, a risk model (PRELANE score), including factors of lymphovascular invasion, Furman grade and tumor stage, had been recently developed and validated on the basis of a large multicenter database of the Western population.3 The present study showed that vascular invasion (including microscopic and gross invasion) at the primary site was the only predictor of late recurrence, and the authors reported that larger primary tumor size and more aggressive tumor pathology might be risk factors of early rather than late recurrence.1 In contrast, a previous study in the Japanese population reported that lymph node metastasis was the only factor to predict late recurrence. 4 Further large Japanese cohort studies will be expected to determine risk factors of late recurrence in Japanese RCC patients and to compare the findings with those in Western patients.From the results regarding risk factors of late recurrence in the present study, the hypothesis that a lower malignant potential of cancer cells results in late recurrence might arise. As expected, Kaplan-Meier curves showed better overall and disease-specific survivals in patients with late than in those with early recurrence, and this finding was consistent with that of a previous study.5 However, four (9.8%) patients with late recurrence had rapid disease progression and died within 1 year after recurrence. Alterations in the character of cancer before the recurrence clinically emerged were suggested, and the pathological and molecular mechanisms of these alterations should be elucidated in further examinations as the next challenging issue.

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confidence: 85%

“…However, both Kroger et al . and Fujii et al . did not include patients without recurrence after 5 years of radical surgery.…”

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confidence: 99%

Editorial Comment from Dr Izumi to Clinicopathological features and outcomes in patients with late recurrence of renal cell carcinoma after radical surgery

Izumi

2015

Int J of Urology

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“…However, how the conversion of disseminated dormant tumor cells to a proliferative state is regulated is still uncertain. Nonetheless, regulation of the growth from dormant tumor cells may be explained in part through the interaction of the tumor cells with their microenvironment, limitations in vascular supply, or an active immune system [25,30]. Thus, it may take years before such dormant tumor cells become detectable metastatic sites, depending on the immunogenic status of dormancy [25,31].…”

Section: Discussionmentioning

confidence: 99%

“…They also found that patients with early recurrence showed poor cancer-specific survival (CSS) after recurrence compared with those with late recurrence. Fujii et al [25] evaluated the clinicopathological characteristics and identified risk factors in patients with early recurrence (≤ 5 years, n = 77) and late recurrence (> 5 years, n = 18) following initial surgery for renal cell carcinoma. They found that patients with early recurrence had higher stage, higher grades and more LVSI compared with those with late recurrence.…”

Section: Discussionmentioning

confidence: 99%

Late Recurrence of Early Stage Cervical Cancer more than 3 Years after Radical Hysterectomy with Pelvic Node Dissection

Hanprasertpong¹,

Jiamset²

2017

Oncol Res Treat

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Background: The aim of this study was to compare the clinicopathological characteristics and outcomes of patients who developed late recurrence (> 3 years) of early stage cervical cancer after radical surgery with those of patients who developed early recurrence (≤ 3 years). We also investigated the risk factors of late recurrence. Methods: The records of 515 patients with early stage cervical cancer diagnosed between 1999 and 2015 were reviewed. 53 patients developed recurrence, 35 early and 18 late, and their clinicopathological characteristics and outcomes were compared. Of the 515 patients, the records for 307 patients who remained tumor free for at least 3 years after radical surgery were further examined. Results: No significant differences were found in clinicopathological characteristics and clinical outcomes between the early and late recurrence groups with regard to age, stage, histology, tumor size, lymphovascular space invasion, stromal invasion, parametrial involvement, node status, vaginal margin, preoperative blood testing, adjuvant therapy, symptom status at recurrence, site of recurrence and survival after recurrence. Late recurrence was detected in 18 of the 307 patients (5.9%). Only node status and deep stromal invasion (DSI) were independently associated with late recurrence. Conclusion: Lymph node metastasis and DSI are risk factors for late recurrence. Careful long-term follow-up is needed, particularly in cases with lymph node metastasis and/or DSI.

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“…Comparing the characteristics between the E-group and the L-group, mitotic count was significantly lower in the L-group than that in the E-group. With respect to the relationship between the degree of tumor malignancy and TTR, Fujii et al [21] showed that a lower pathological T stage was significantly more common in the late-recurrence group (after 5 years from resection) than in the early-recurrence group (within 5 years from resection) in patients with renal cell carcinoma. Oven et al [22] also showed a similar tendency in breast cancer patients.…”

Section: Discussionmentioning

confidence: 99%

Appropriate Follow-Up Strategies for Gastrointestinal Stromal Tumor Patients Based on the Analysis of Recurrent Interval and Patterns

et al. 2017

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Background/Aims: Previous studies have proposed risk classifications for patients with gastrointestinal stromal tumor (GIST) after resection and have contributed to the prediction of its prognosis. However, optimal postoperative surveillance has not yet been established. Methods: We retrospectively analyzed data from 115 GIST patients who experienced recurrence after complete resection. The relationships between clinicopathological characteristics and the first recurrence sites, or time to recurrence (TTR), were investigated. We also compared the characteristics between 2 subgroups based on a TTR of ≤5 or >5 years. Results: The first recurrence occurred in the abdomen in 114 of 115 patients (99.1%); one case of esophageal GIST recurred in the lung. Gastric and small intestinal GISTs recurred most frequently in the liver or peritoneum, while the most common recurrences of colorectal GISTs were found to be local. Fourteen patients (12.2%) experienced recurrence after >5 years. Smaller tumors and those categorized as lower risk were significantly more frequent in the TTR >5 years group than in the TTR ≤5 years group. In the TTR >5 years group, local recurrence was the most frequent type of recurrence (42.9%). Conclusion: Based on abdominal examination, postoperative surveillance after complete resection for primary GISTs may be recommended for >5 years.

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Different clinicopathological features between patients who developed early and late recurrence following surgery for renal cell carcinoma

Cited by 16 publications

References 31 publications

Editorial Comment from Dr Izumi to Clinicopathological features and outcomes in patients with late recurrence of renal cell carcinoma after radical surgery

Editorial Comment from Dr Izumi to Clinicopathological features and outcomes in patients with late recurrence of renal cell carcinoma after radical surgery

Late Recurrence of Early Stage Cervical Cancer more than 3 Years after Radical Hysterectomy with Pelvic Node Dissection

Appropriate Follow-Up Strategies for Gastrointestinal Stromal Tumor Patients Based on the Analysis of Recurrent Interval and Patterns

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