Local Treatment of Recurrent Renal Cell Carcinoma May Have a Significant Survival Effect Across All Risk-of-recurrence Groups

The Decision to Surgically Resect Recurrent Renal Cell Carcinoma: More Evidence that Careful Case Selection by Surgeons Is Associated with Better Survival

“…Lastly, in a study of complete metastasectomy in 138 patients managed from 1990 to 2013 across numerous organ sites, factors adversely affecting cancer-specific survival were a shorter interval from nephrectomy to recurrence, multiple tumors resected at a single site, larger tumors at the time of nephrectomy, and sarcomatoid histology [10] . In this study, performed during the expansion of MIS kidney surgery between 2006 and 2011, Marconi et al [5] observed a higher rate of abdominal recurrences in the no-LTR group. This could speak to a growing concern related to atypical tumor recurrences following MIS PN and RN leading to port-site recurrence and carcinomatosis often not amenable to resection [11] .…”

“…In their study published in European Urology Open Science , Marconi et al [5] used the RECUR multi-institutional kidney cancer registry involving 15 European centers to determine if local treatment of recurrence (LTR) provides a survival benefit. A total of 3039 patients with localized renal cell carcinoma (RCC) were treated with curative intent using partial nephrectomy (PN) or radical nephrectomy (RN) (>1000 had MIS) between 2006 and 2011.…”

Redo Partial Nephrectomy for Local Recurrence After Previous Nephron-sparing Surgery. Surgical Insights and Oncologic Results from a High-volume Robotic Center

“…Rising enthusiasm for NSS has progressively led to the expansion of PN indication to highly complex and cT2 renal tumors, demonstrating favorable functional and oncologic outcomes in experienced centers [18] , [19] . On the contrary, such an attitude may unequivocally result in a higher risk for PSMs, tumor upstaging, and a risk for tumor recurrence after NSS, as a direct consequence of the increasing complexity of renal tumors potentially amenable to PN [20] , [21] . In this scenario, there is a growing interest among PN surgeons to understand whether redo PN may be a feasible and safe treatment option for locally recurrent RCC.…”

Downstaging and Pathological Complete Response of Locally Recurrent Sarcomatoid Renal Cell Carcinoma under Pembrolizumab and Lenvatinib: A Case Report and Review of Literature

“…In accordance with established guidelines, recent data have reinforced the potential benefit of active local treatment of recurrent RCC. While some selection bias may have skewed results, patients who underwent local treatment of recurrence had an overall survival of 70.3 months (95% confidence interval 58–82.6 months), compared to 27.4 months (95% confidence interval 23.6–31.15 months) in patients not receiving local treatment of recurrence [ 5 ]. If metastasis resection or radiotherapeutic ablative techniques are not feasible, systemic therapy is a well-established approach for treating metastatic RCC (mRCC); however, it is not considered curative.…”