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Renal cell carcinoma recurrences and metastases in primary non-metastatic patients: a population-based study

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Abstract

Purpose

To present the occurrence of metastases and local recurrences in primary non-metastatic patients with renal cell carcinoma (RCC) in a contemporary Swedish population-based cohort.

Methods

Between 2005 and 2009, a total of 4527 patients were included in the prospective National Swedish Kidney Cancer Register accounting for nearly all RCC patients in Sweden. Among M0 patients, 472 (13 %) had no follow-up data registered within 5-year follow-up time and were excluded from the analysis.

Results

In total, 939 (21 %) had distant metastases at presentation with a decrease from 23 to 18 % during the inclusion period. Of 3107 patients with follow-up data and with M0 disease, 623 (20 %) were diagnosed with a tumor recurrence during 5-year follow-up. Mean time to recurrence was 24 months (SD ± 20 months). Among these, 570 patients (92 %) were at primary diagnosis treated with radical nephrectomy, 23 patients (3.7 %) with partial nephrectomy and 12 patients (1.9 %) with minimally invasive treatments. The most frequent sites of metastases were lung (54 %), lymph nodes (22 %) and bone (20 %). The treatment of recurrence was in 50 % systemic treatments, while metastasectomy was performed in 17 % of the patients, out of which 68 % were with a curative intention.

Conclusions

In this population-based study, 21 % of the patients had metastatic disease at presentation, with a decreasing trend over the study period. During 5-year follow-up, 20 % of the primary non-metastatic patients had recurrent disease. Of the patients with recurrence, half were given systemic oncological treatment and 17 % underwent metastasectomy.

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Acknowledgments

The members of the NSKCR are as follows: Börje Ljungberg (chairman), Stina Christensen, Britt-Inger Dahlin, Peter Elfving, Ulrika Harmenberg, Benny Holmström, Annika Håkansson, Åsa Jellvert, Per Lindblad, Magnus Lindskog, Sven Lundstam, Ann-Helén Scherman-Plogell, Emma Ulvskog and Janos Vasko. The authors thank Soheila Hosseinnia and other collaborators at the Regional Cancer Centre, Stockholm, for providing statistical analysis from the NSKCR. This study was supported by grants from Umeå University, Lions Cancer Research Foundation in Umeå (Börje Ljungberg), the Research Foundation at the Urology Department of Sahlgrenska University Hospital and the Foundation of Anna-Lisa and Bror Björnsson (Sven Lundstam).

Authors’ contribution

SD involved in data collection and management, data analysis, wrote and edited the manuscript; AT involved in data collection and management, data analysis and edited the manuscript; PL involved in data collection and management and edited the manuscript; UH involved in data collection and management and edited the manuscript; BL involved in project development, data collection and management, data analysis, wrote and edited the manuscript; SL involved in project development, data collection and management, data analysis, wrote and edited the manuscript.

Author information

Authors and Affiliations

  1. Department of Urology, Skåne University Hospital, 205 02, Malmö, Sweden

    Saeed Dabestani

  2. Section of Urology, Department of Molecular Medicine and Surgery, Karolinska Institute, 171 64, Solna, Stockholm, Sweden

    Andreas Thorstenson

  3. Department of Urology, Faculty of Medicine and Health, Örebro University, 701 85, Örebro, Sweden

    Per Lindblad

  4. Department of Oncology, Karolinska University Hospital, 171 64, Solna, Stockholm, Sweden

    Ulrika Harmenberg

  5. Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, 901 85, Umeå, Sweden

    Börje Ljungberg

  6. Department of Urology, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden

    Sven Lundstam

Authors
  1. Saeed Dabestani
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  2. Andreas Thorstenson
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  3. Per Lindblad
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  4. Ulrika Harmenberg
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  5. Börje Ljungberg
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  6. Sven Lundstam
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Corresponding author

Correspondence to Börje Ljungberg.

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The authors report no conflicts of interest.

Additional information

For the National Swedish Kidney Cancer Register Group.

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Dabestani, S., Thorstenson, A., Lindblad, P. et al. Renal cell carcinoma recurrences and metastases in primary non-metastatic patients: a population-based study. World J Urol 34, 1081–1086 (2016). https://doi.org/10.1007/s00345-016-1773-y

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  • DOI: https://doi.org/10.1007/s00345-016-1773-y

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