Prediction of clinically significant recurrence after partial nephrectomy. Data from the Cancer Registry of Norway with more than five years of follow-up

Ovidiu S. Barnoiu; Tom B. Johannesen; Lien M. Diep; Eskil S. Pedersen; Karin M. Hjelle; Christian Beisland

doi:10.2340/sju.v59.18674

Authors

Ovidiu S. Barnoiu Department of Urology, Sorlandet Hospital, Kristiansand, Norway https://orcid.org/0000-0003-3347-1645
Tom B. Johannesen Cancer Registry of Norway, Oslo, Norway
Lien M. Diep OCBE, Research Support Services, Oslo University Hospital, Oslo, Norway
Eskil S. Pedersen Department of Urology, Sorlandet Hospital, Kristiansand, Norway
Karin M. Hjelle Department of Urology, Haukeland University Hospital, Bergen, Norway
Christian Beisland Department of Urology, Haukeland University Hospital, Bergen, Norway

DOI:

https://doi.org/10.2340/sju.v59.18674

Keywords:

local recurrence, metastasis, partial nephrectomy, predictive model, Renal Cell Carcinoma

Abstract

Objective: To determine recurrence incidence after partial nephrectomy (PN) for renal cell carcinoma and identify predictors for local recurrence (LR) and metastasis.

Material and methods: We retrospectively evaluated a cohort of 524 patients from the Cancer Registry of Norway, who underwent PN between January 2014 and December 2015 and were followed-up for >6 years. Patient demographics and pathological characteristics were correlated with recurrence and progression-free survival using Kaplan-Meier and Cox regression analyses.

Results: Median patient age was 64 years, and the median tumour size was 2.6 cm. A positive surgical margin (PSM) was observed in 11% of the cases, while the LR and metastasis rates were 3.4% and 3.2%, respectively. PSM (hazard ratio [HR], 55.4; 95% confidence interval [CI], 12.55–244.6), tumour number (HR, 45.4; 95% CI, 6.5–316.1) and stage (HR, 33.5; 95% CI, 5.4–205.3) were independent predictors for LR. Undetermined margin status was also a risk factor for LR. Tumour stage (HR, 41.05; 95% CI, 8.52–197.76), tumour necrosis (HR, 1.3; 95% CI, 0.4–4.31) and age (HR, 1.07; 95% CI, 1.01–1.14) were predictors for metastasis.

Conclusions: Both local and distant recurrences after PN were rare, and the pT stage was a common predictor. PSM or indeterminate surgical margin and tumour number were LR predictors, while age at surgery and the presence of tumour necrosis predicted metastasis.

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