Increased use of cross-sectional imaging for follow-up does not improve post-recurrence survival of surgically treated initially localized R.C.C. results from a European multicenter database (R.E.C.U.R.)

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

Abstract

Objective: Modality and frequency of image-based renal cell carcinoma (R.C.C.) follow-up strategies are based on risk of recurrence. Using the R.E.C.U.R.-database, frequency of imaging was studied in regard to prognostic risk groups. Furthermore, it was investigated whether imaging modality utilized in contemporary follow-up were associated with outcome after detection of recurrence. Moreover, outcome was compared based on whether the assessment of potential curability was a pre-defined set of criteria’s (per-protocol) or stated by the investigator. Materials and methods: Consecutive non-metastatic R.C.C. patients (n = 1,612) treated with curative intent at 12 institutes across eight European countries between 2006 and 2011 were included. Leibovich or U.I.S.S. risk group, recurrence characteristics, imaging modality, frequency and survival were recorded. Primary endpoints were overall survival (O.S.) after detection of recurrence and frequency of features associated with favourable outcome (non-symptomatic recurrences and detection within the follow-up-programme). Results: Recurrence occurred in 336 patients. Within low, intermediate and high risk for recurrence groups, the frequency of follow-up imaging was highest in the early phase of follow-up and decreased significantly over time (p < 0.001). However, neither the image modality for detection nor ≥ 50% cross-sectional imaging during follow-up were associated with improved O.S. after recurrence. Differences between per protocol and investigator based assessment of curability did not translate into differences in O.S. Conclusions: As expected, the frequency of imaging was highest during early follow-up. Cross-sectional imaging use for detection of recurrences following surgery for localized R.C.C. did not improve O.S. post-recurrence. Prospective studies are needed to determine the value of imaging in follow-up.

Detaljer

Författare
  • Saeed Dabestani
  • Christian Beisland
  • Grant D. Stewart
  • Karim Bensalah
  • Eirikur Gudmundsson
  • Thomas B. Lam
  • William Gietzmann
  • Paimaun Zakikhani
  • Lorenzo Marconi
  • Sergio Fernandéz-Pello
  • Serenella Monagas
  • Samuel P. Williams
  • Thomas Powles
  • Erik Van Werkhoven
  • Richard Meijer
  • Alessandro Volpe
  • Michael Staehler
  • Börje Ljungberg
  • Axel Bex
Enheter & grupper
Externa organisationer
  • Skåne University Hospital
  • Haukeland University Hospital
  • University of Bergen
  • University of Cambridge
  • National University Hospital of Iceland
  • University of Aberdeen
  • University Hospital of Coimbra
  • Queen Mary University
  • Netherlands Cancer Institute
  • University Medical Center Utrecht
  • University of Eastern Piedmont
  • Ludwig-Maximilian University of Munich
  • Umeå University
  • University of Rennes I
  • Aberdeen Royal Infirmary
  • University Hospital Cabueñes
  • San Agustin University Hospital
  • University of Edinburgh
Forskningsområden

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Urologi och njurmedicin

Nyckelord

Originalspråkengelska
Sidor (från-till)14-20
TidskriftScandinavian Journal of Urology
Volym53
Utgivningsnummer1
Tidigt onlinedatum2019
StatusPublished - 2019
PublikationskategoriForskning
Peer review utfördJa