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dc.contributor.authorAbu-Ghanem, Yasmin
dc.contributor.authorPowles, Thomas
dc.contributor.authorCapitanio, Umberto
dc.contributor.authorBeisland, Christian
dc.contributor.authorJärvinen, Petrus
dc.contributor.authorStewart, Grant D
dc.contributor.authorGudmundsson, Eirikur
dc.contributor.authorLam, Thomas B L
dc.contributor.authorMarconi, Lorenzo
dc.contributor.authorFernandéz-Pello, Sergio
dc.contributor.authorNisen, Harry
dc.contributor.authorMeijer, Richard P
dc.contributor.authorVolpe, Alessandro
dc.contributor.authorLjungberg, Börje
dc.contributor.authorKlatte, Tobias
dc.contributor.authorBensalah, Karim
dc.contributor.authorDabestani, Saeed
dc.contributor.authorBex, Axel
dc.date.accessioned2021-08-23T10:48:17Z
dc.date.available2021-08-23T10:48:17Z
dc.date.issued2021-04-01
dc.date.submitted2021-08
dc.identifier.citationA, Ljungberg B, Klatte T, Bensalah K, Dabestani S, Bex A. Should patients with low-risk renal cell carcinoma be followed differently after nephron-sparing surgery vs radical nephrectomy? BJU Int. 2021 Apr 1. doi: 10.1111/bju.15415. Epub ahead of print.en_US
dc.identifier.pmid33794055
dc.identifier.doi10.1111/bju.15415
dc.identifier.urihttp://hdl.handle.net/2336/621847
dc.descriptionTo access publisher's full text version of this article click on the hyperlink belowen_US
dc.description.abstractObjective: To investigate whether pT1 renal cell carcinoma (RCC) should be followed differently after partial (PN) or radical nephrectomy (RN) based on a retrospective analysis of a multicentre database (RECUR). Subjects: A retrospective study was conducted in 3380 patients treated for nonmetastatic RCC between January 2006 and December 2011 across 15 centres from 10 countries, as part of the RECUR database project. For patients with pT1 clear-cell RCC, patterns of recurrence were compared between RN and PN according to recurrence site. Univariate and multivariate models were used to evaluate the association between surgical approach and recurrence-free survival (RFS) and cancer-specific mortality (CSM). Results: From the database 1995 patients were identified as low-risk patients (pT1, pN0, pNx), of whom 1055 (52.9%) underwent PN. On multivariate analysis, features associated with worse RFS included tumour size (hazard ratio [HR] 1.32, 95% confidence interval [CI] 1.14-1.39; P < 0.001), nuclear grade (HR 2.31, 95% CI 1.73-3.08; P < 0.001), tumour necrosis (HR 1.5, 95% CI 1.03-2.3; P = 0.037), vascular invasion (HR 2.4, 95% CI 1.3-4.4; P = 0.005) and positive surgical margins (HR 4.4, 95% CI 2.3-8.5; P < 0.001). Kaplan-Meier analysis of CSM revealed that the survival of patients with recurrence after PN was significantly better than those with recurrence after RN (P = 0.02). While the above-mentioned risk factors were associated with prognosis, type of surgery alone was not an independent prognostic variable for RFS nor CSM. Limitations include the retrospective nature of the study. Conclusion: Our results showed that follow-up protocols should not rely solely on stage and type of primary surgery. An optimized regimen should also include validated risk factors rather than type of surgery alone to select the best imaging method and to avoid unnecessary imaging. A follow-up of more than 3 years should be considered in patients with pT1 tumours after RN. A novel follow-up strategy is proposed. Keywords: #Kidney Cancer; #kcsm; #uroonc; RECUR; follow up; guidelines; partial nephrectomy; radical nephrectomy; renal cell carcinoma; survival.en_US
dc.language.isoenen_US
dc.publisherWileyen_US
dc.relation.urlhttps://bjui-journals.onlinelibrary.wiley.com/doi/10.1111/bju.15415en_US
dc.rights© 2021 The Authors BJU International © 2021 BJU International.
dc.subject#Kidney Canceren_US
dc.subject#kcsmen_US
dc.subject#urooncen_US
dc.subjectRECURen_US
dc.subjectfollow upen_US
dc.subjectguidelinesen_US
dc.subjectpartial nephrectomyen_US
dc.subjectradical nephrectomyen_US
dc.subjectrenal cell carcinomaen_US
dc.subjectsurvivalen_US
dc.subjectNýrnakrabbameinen_US
dc.subjectSkurðlækningaren_US
dc.subject.meshCarcinoma, Renal Cellen_US
dc.subject.meshNephrectomyen_US
dc.subject.meshAftercareen_US
dc.titleShould patients with low-risk renal cell carcinoma be followed differently after nephron-sparing surgery vs radical nephrectomy?en_US
dc.typeArticleen_US
dc.identifier.eissn1464-410X
dc.contributor.department1UCL Division of Surgical and Interventional Science, Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, London, UK. 2Barts Cancer Institute, Queen Mary University of London, London, UK. 3Division of Experimental Oncology, Urological Research Institute (URI), IRCCS Ospedale San Raffaele, Milan, Italy. 4Department of Urology, Haukeland University Hospital, Bergen, Norway. 5Department of Clinical Medicine, University of Bergen, Bergen, Norway. 6Urology, Abdominal Centre, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 7Department of Surgery, University of Cambridge, Cambridge, UK. 8Department of Urology, Landspitali University Hospital, Reykjavik, Iceland. 9Academic Urology Unit, University of Aberdeen, Aberdeen, UK. 10Department of Urology, Coimbra University Hospital, Coimbra, Portugal. 11Department of Urology, Cabueñes University Hospital, Gijón, Spain. 12Department of Oncological Urology, University Medical Centre Utrecht, Utrecht, The Netherlands. 13Department of Urology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy. 14Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden. 15Department of Urology, Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Bournemouth, UK. 16Department of Urology, University Hospital of Rennes, Rennes, France. 17Division of Urological Cancers, Department of Translational Medicine, Central Hospital Kristianstad, Lund University, Lund, Sweden. 18Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands.en_US
dc.identifier.journalBJU internationalen_US
dc.rights.accessNational Consortium - Landsaðganguren_US
dc.departmentcodeURO12
dc.source.journaltitleBJU international
dc.source.countryEngland


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