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Study Findings Support Surveillance Imaging Past 5 Years Postsurgery in RCC
Findings from a post hoc analysis support the use of surveillance imaging beyond 5 years after surgical resection in patients with intermediate- to high-risk renal cell carcinoma (RCC; Eur Urol. 2019 Nov 5. Epub ahead of print).
“Currently, surveillance guidelines following surgical resection of clinically localized…RCC…are clear within the first 5 [years]…however, these lack the same degree of objectivity following this cutoff,” explained Marcus L. Jamil, MD, Vattikuti Urology Institute Center for Outcomes Research, Analytics and Evaluation, Henry Ford Health System, Detroit, Michigan, and colleagues.
To determine the utility of long-term surveillance in this setting, Dr Jamil et al evaluated the long-term risk for recurrence in patients with surgically treated RCC through a post hoc analysis of patients in the Eastern Cooperative Oncology Group-American College of Radiology Imaging Network E2805 trial cohort.
Postsurgery, the 36-month cumulative incidence of recurrence was evaluated at set intervals via a conditional survival model. Among 1943 patients included in the original cohort, disease recurrence occurred in 730. The 36-month cumulative incidences of recurrence were 31%, 26%, 19%, 16%, 19%, and 20% for patients at 0, 12, 24, 36, 48, and 60 months postsurgery, respectively.
At 0 months from surgery, independent predictors of recurrence included age, pathological T3/4 stage (hazard ratio [HR], 1.56), pathological N1/2 stage (HR, 2.38), and Fuhrman grades 3 and 4 (HR, 1.36 and HR, 2.41, respectively); this was not observed 60 months postsurgery.
“These findings support that surveillance imaging should be performed beyond 5 yr [years] following surgical resection of intermediate- to high-risk RCC,” Dr Jamil and co-investigators concluded.—Hina Porcelli
