A clinical investigation of recurrence and lost follow-up after renal cell carcinoma surgery: a single-center, long-term, large cohort, retrospective study
A clinical investigation of recurrence and lost follow-up after renal cell carcinoma surgery: a single-center, long-term, large cohort, retrospective study
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DOI：
10.1007/s10147-022-02204-x
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发表时间：
2022-06-29
影响因子：
3.3
通讯作者：
Ichikawa, Tomohiko
中科院分区：
文献类型：
--
作者：
Arai, Takayuki;Sazuka, Tomokazu;Ichikawa, Tomohiko
背景肾细胞癌（RCC）术后晚期复发是一种常见的并发症。此外，这些患者中的一些患者失去了长期的术后随访。我们回顾了千叶大学附属医院肾细胞癌术后患者的治疗结果和预后，旨在阐明失访患者的比例和背景。方法回顾性分析1176例肾癌患者行根治性或/和肾部分切除术的临床资料。评估了总生存期（OS）、癌症特异性生存期（CSS）、无复发生存期（RFS）和无失访生存期（LFFS），并确定了LFFS的风险因素。结果Ⅱ期和Ⅱ期患者的中位RFS分别为188.3和104.0个月。即使在I期，术后20年约有20%的患者复发。LFFS的Kaplan-Meier曲线显示随时间线性下降，50%的患者在25年内失访。高龄（≥ 62岁）、组织学类型（透明细胞肾细胞癌）和无复发是失访的重要危险因素。结论肾癌术后晚期复发的病例并不少见，应长期随访。我们认为，终身随访的影像学检查是推荐术后RCC患者。早期发现术后患者的复发是一个非常重要的问题，关注可能被忽视的失访患者可能有助于改善术后患者的预后。
Background Late recurrence of renal cell carcinoma (RCC) is observed in some postoperative patients. In addition, some of these patients are lost to long-term postoperative follow-up. We reviewed the treatment results and prognosis of postoperative patients with RCC at Chiba University Hospital, with the aim of clarifying the proportion and background of patients lost to follow-up. Methods This retrospective study included 1176 RCC patients who underwent radical or/and partial nephrectomy. Overall survival (OS), cancer-specific survival (CSS), recurrence-free survival (RFS), and lost follow-up free survival (LFFS) were evaluated and the risk factors for LFFS identified. Results The median RFS for stage II and II cases was 188.3 and 104.0 months, respectively. Even in stage I, recurrence was observed in about 20% of patients 20 years after surgery. The Kaplan-Meier curve for LFFS showed a linear descent over time, with 50% of patients lost to follow-up within 25 years. Older age (>= 62 years), histological type (clear cell RCC), and no recurrence were significant risk factors for lost follow-up. Conclusions Long-term follow-up is necessary after RCC surgery because late recurrence cases are not uncommon. We believe that lifelong follow-up with imaging studies is recommended for postoperative RCC patients. Early detection of recurrence in postoperative patients is a very important issue, and it may be worthwhile for improving the prognosis of postoperative patients to focus on patients lost to follow-up who may have been overlooked.