Is Late Recurrence a Predictive Clinical Marker for Better Sunitinib Response in Metastatic Renal Cell Carcinoma Patients?

Bozkurt, Oktay; Hacıbekiroğlu, İlhan; Kaplan, Mehmet Ali; Düzköprü, Yakup; Uysal, Mükremın; Karaca, Halıt; Berk, Velı; İnanç, Mevlüde; Duran, Ayşe Ocak; Özaslan, Ersin; Uçar, Mahmut; Özkan, Metin

doi:10.1016/j.clgc.2015.07.005

“…Bozkurt et al. [31] also demonstrated the better prognostic value of late recurrence in terms of PFS and OS. In an Italian multicenter study researchers retrospectively investigated the clinicopathological features and the outcome of patients with late recurrent RCC.…”

Section: Discussionmentioning

confidence: 94%

“…There are several retrospective studies in Canada, Japan, Korean and Italy [7] , [16] , [19] , [31] . However, some viewpoints are still in dispute, such as prognosis and the predictive factors for late recurrence.…”

Section: Discussionmentioning

confidence: 99%

Asynchronous abdominal wall and sigmoid metastases in clear cell renal cell carcinoma: A case report and literature review

Zhang

¹

,

Zhao

²

,

Wu

³

et al. 2019

Asian Journal of Urology

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Sigmoid metastasis of renal cell carcinoma (RCC) is very rare. Herein we report a case of pathologically proven asynchronous abdominal wall and sigmoid metastases after a right nephrectomy. An 84-year-old man underwent right radical nephrectomy for clear cell renal cell carcinoma (ccRCC) 13 years ago. Solitary contralateral abdominal wall metastasis was found for left abdominal mass 9 years after nephrectomy. The man experienced melena underwent resection of sigmoid colon tumor in February, 2016. The postoperative pathological examinations revealed that the tumors were metastases of ccRCC. Recurrence more than 5 years after nephrectomy has been accepted as late recurrence by the majority of urologists now. Late recurrence is one of the specific biological behaviors of RCC. Asynchronous late recurrence of abdominal wall and sigmoid metastases in ccRCC has not been reported before. When patients have sigmoid mass after nephrectomy for RCC, doctors may consider the possibility of late recurrence.

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“…Bozkurt et al reported that patients with LR had a better response to sunitinib than did those with ER. 5 Although slow growth might be a characteristic of LR, it is still unclear whether there are differences in responses to treatments such as molecular targeted therapies, cytokine therapies, and metastasectomy between ER and LR. Further larger studies are warranted to clarify the difference of response to treatments between ER and LR, and the best follow-up schedule to appropriately identify recurrence in patients with RCC during a long follow-up period.…”

Section: Editorial Commentmentioning

confidence: 99%

“…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.…”

mentioning

confidence: 97%

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

Kitagawa

¹

2015

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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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“…Bozkurt et al . reported that patients with LR had a better response to sunitinib than did those with ER . Although slow growth might be a characteristic of LR, it is still unclear whether there are differences in responses to treatments such as molecular targeted therapies, cytokine therapies, and metastasectomy between ER and LR.…”

mentioning

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

¹

2015

Int J of Urology

0

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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.

show abstract

Is Late Recurrence a Predictive Clinical Marker for Better Sunitinib Response in Metastatic Renal Cell Carcinoma Patients?

Cited by 11 publications

References 24 publications

Asynchronous abdominal wall and sigmoid metastases in clear cell renal cell carcinoma: A case report and literature review

Asynchronous abdominal wall and sigmoid metastases in clear cell renal cell carcinoma: A case report and literature review

Editorial Comment from Dr Kitagawa 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

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