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New Classification System to Track Local Recurrence of Kidney Cancers

By: Sara Tewksbury
Posted: Friday, February 7, 2020

Researchers from Fox Chase Cancer Center, Philadelphia, have developed a new classification system to track local recurrence of renal cell carcinoma after surgery. Robert G. Uzzo, MD, MBA, FACS, of the Department of Surgical Oncology at Fox Chase Cancer Center, and colleagues used data from the largest national adjuvant clinical trial in kidney cancer to date to try to better define local recurrence and how frequently it occurred after surgery. Their findings were published in The Journal of Urology.

“When people use the term ‘local recurrence,’ everyone uses it differently,” Dr. Uzzo said in a Fox Chase press release. “We developed a framework for people to define what local recurrence means, and then we looked to see whether local recurrence is associated with better or worse survival.”

Researchers analyzed data on 1,943 patients from the ASSURE trial and found that 300 (15%) experienced recurrence. The recurrences were designated as type I, single recurrence in remnant kidney or ipsilateral renal fossa; type II, single recurrence in the ipsilateral vasculature, the ipsilateral adrenal gland, or a lymph node; type III, single recurrence in other intra-abdominal soft tissues or organs; and type IV, any combination of types I, II, or III or multiple recurrences of a single type.

Of the cancers that recurred, 22% were type I, 32% were type II, 29% were type III, and 17% were type IV. Both 5-year cancer-specific survival and overall survival were worse among patients with type IV local recurrence. Of note, the researchers found that the type of surgery and surgical modality did not seem to predict whether a patient would have local recurrence or not.

“We are encouraging people now to be specific about how they define local recurrence and, potentially, use our framework as an objective way to understand survival data,” Dr. Uzzo concluded.

Disclosure: For full disclosures of the study authors, visit auajournals.org.



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