Recurrence in Localized Renal Cell Carcinoma: a Systematic Review of Contemporary Data
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Purpose of Review
Patients with localized renal cell carcinoma (RCC) are at risk of recurrence. The purpose of this review was to characterize the literature on recurrence rates and risk factors after diagnosis of localized RCC.
Our search revealed that existing data examining the prevalence of recurrence rates predominantly originates from cohorts of patients diagnosed and treated in the 1980s to 1990s, and may therefore not be as useful for counseling for current patients today. Many nomograms including the Cindolo Recurrence Risk Formula, the University of California-Los Angeles (UCLA) Integrated Scoring System (UISS), the SSIGN score, the Kattan nomogram, and the Karakiewicz nomogram have shown value in identifying patients at higher risk for recurrence. Biomarkers and gene assays have shown promise in augmenting the predictive accuracy of some of the aforementioned predictive models, especially when multiple gene markers are used in combination. However, more work is needed in not only developing a model but also validating it in other settings prior to clinical use. Adjuvant therapy is a promising new treatment strategy for patients with high-risk disease. Importantly, too many surveillance strategies exist. This may stem from the lack of a consensus in the urological community in how to follow these patients, as well as the variable guideline recommendations.
In conclusion, contemporary recurrence rates are needed. Recurrence risk prediction models should be developed based on a series of more contemporary patients, and externally validated prior to routine clinical practice. Surveillance strategies following treatment of localized RCC need to be identified and standardized. Finally, there is a trend toward personalizing surveillance regimens to more appropriately screen patients at higher risk of recurrence.
KeywordsRecurrent renal cell carcinoma Surveillance in renal cell Biomarkers in renal cell Risk factors for renal cell recurrence Localized renal cell carcinoma Treatment of localized renal cell carcinoma
Compliance with Ethical Standards
Conflict of Interest
Jacqueline M. Speed, Quoc-Dien Trinh, Toni K. Choueiri, and Maxine Sun each declare no potential conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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