NEW ORLEANS, LA USA (UroToday.com) - Given the impact of detection rate of imaging on clinical decision making for kidney cancer surveillance, the authors of this study sought to examine the rate and mode of relapse detection in a retrospective study of n=1405 patients with low risk kidney cancer who were treated with partial or radical nephrectomy.
The authors performed a retrospective analysis of 1 405 patients with pT1 kidney cancer. All patients were treated by either partial or radical nephrectomy from 2000-2012. Average patient age was 58.4 with ASA score I/II (59%) and score II/III (49%). Pathological grade was n=84 (8.0%), n=615 (59%), n= 336 (32%), and n= 10 (1%) for G1, G2, G3, and G4, respectively. Pathological stage for T1A was n=1025 (73%) and n= 380 (27%) for T1B. Tumor presentation was incidental in 84% of cases, 15% in local, and 0.8% in systemic. Following surgery and before relapse, scans for chest and abdominal imaging were performed and charted for all patients. The authors also recorded anatomic site, mode of detection, and presence or absence of symptoms.
Twenty-one patients had a relapse, with a median follow-up of 4.1 years for patients who did not relapse. Of the 21 relapses, 17 were detected by imaging alone while the remaining presented with symptoms. In just the first 3 years observed in this study, 10 relapses were detected, 8 of which were detected by imaging alone.
The authors conclude that their findings support AUA “guideline recommendations for more judicious use of surveillance imaging in the first 3 years for low-risk patients as there is a low-rate of relapse. Nearly a quarter of patients with relapse are detected by symptoms, and a third of patients detected by imaging will not require immediate treatment.”
Presented by Michael Feuerstein at the American Urological Association (AUA) Annual Meeting - May 15 - 19, 2015 - New Orleans, LA USA
Memorial Sloan Kettering Cancer Center, New York, NY USA
Reported by Renai Yoon (University of California-Irvine), medical writer for UroToday.com