Validation of risk factors for recurrence of renal cell carcinoma: Results from a large single-institution series

Abstract

PurposeTo validate prognostic factors and determine the impact of obesity, hypertension, smoking and diabetes mellitus (DM) on risk of recurrence after surgery in patients with localized renal cell carcinoma (RCC).Materials and methodsWe performed a retrospective cohort study among patients that underwent partial or radical nephrectomy at Weill Cornell Medicine for RCC and collected preoperative information on RCC risk factors, as well as pathological data. Cases were reviewed for radiographic evidence of RCC recurrence. A Cox proportional-hazards model was developed to determine the contribution of RCC risk factors to recurrence risk. Disease-free survival and overall survival were analyzed using the Kaplan-Meier method and log-rank test.ResultsWe identified 873 patients who underwent surgery for RCC between the years 2000–2015. In total 115 patients (13.2%) experienced a disease recurrence after a median follow up of 4.9 years. In multivariate analysis, increasing pathological T-stage (HR 1.429, 95% CI 1.265–1.614) and Nuclear grade (HR 2.376, 95% CI 1.734–3.255) were independently associated with RCC recurrence. In patients with T1-2 tumors, DM was identified as an additional independent risk factor for RCC recurrence (HR 2.744, 95% CI 1.343–5.605). Patients with DM had a significantly shorter median disease-free survival (1.5 years versus 2.6 years, p = 0.004), as well as median overall survival (4.1 years, versus 5.8 years, p<0.001).ConclusionsWe validated high pathological T-stage and nuclear grade as independent risk factors for RCC recurrence following nephrectomy. DM is associated with an increased risk of recurrence among patients with early stage disease.

MicroRNA‐100 Enhances Autophagy and Suppresses Migration and Invasion of Renal Cell Carcinoma Cells via Disruption of NOX4‐Dependent mTOR Pathway

“… 3 No apparent symptoms or any laboratory abnormalities are detectable at the very early phase of RCC. 4 Several therapeutic protocols have been developed for RCC in the clinical setting, such as targeted therapy 5 and surgical resection, which presents with an excellent long‐term disease‐free survival, whereas 20–50% of patients have manifested metastasis or local recurrence after resection solemnly. 6 Smoking, obesity, hypertension, and diabetes mellitus have been identified as vital risk factors for extensive recurrence after treatment in patients with RCC.…”

“… 6 Smoking, obesity, hypertension, and diabetes mellitus have been identified as vital risk factors for extensive recurrence after treatment in patients with RCC. 5 …”

The Antidiabetic Agent Acarbose Improves Anti-PD-1 and Rapamycin Efficacy in Preclinical Renal Cancer

“…Further, our study included an evaluation of acarbose specifically in renal cancer. The use of nondiabetic, lean mice illustrates the potential for use of acarbose in normoglycemic cancer patients but does not address the potential contributions of acarbose in hyperglycemic individuals, a frequent comorbidity known to increase risk for RCC in women [ 41 ] and worsen survival outcomes for RCC patients [ 42 ]. Acarbose use in these patients may be particularly beneficial.…”

Machine Learning Approach to Predict the Probability of Recurrence of Renal Cell Carcinoma After Surgery: Prediction Model Development Study

“…RCC can be completely cured through full surgical resection if there is no evidence of preoperative metastatic disease. However, it has a high recurrence rate of 20% to 30% [ 8 , 9 ], and approximately 50% of recurrences occur within 2 years [ 8 , 10 ]. RCC recurrence is generally classified as early recurrence or late recurrence based on the 5-year threshold [ 11 ].…”