Recurrence pattern in localized RCC: results from a European multicenter database (RECUR)

Area of Science:

• Urology
• Surgical Oncology
• Oncology

Background:

• The optimal surgical approach for localized renal cell carcinoma (RCC) is debated.
• Uncertainty exists regarding the impact of open versus minimally invasive surgery on recurrence patterns.

Purpose of the Study:

• To compare the impact of open and minimally invasive surgical approaches on survival and recurrence patterns in localized RCC.
• To investigate differences in local recurrence, distant metastases, disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS).

Main Methods:

• Multi-institutional, matched cohort study using the RECUR database.
• Propensity score matching was performed for patients with pT1-3aN0M0 RCC.
• Cox regression analysis assessed recurrence sites (local, abdominal, thoracic, uncommon) and survival outcomes.

Main Results:

• 1,019 patients in each group (open and minimally invasive) were matched.
• Minimally invasive surgery was associated with a higher risk of local recurrence (HR 2.06) and uncommon site metastases (HR 1.09).
• No significant differences were observed in DFS, OS, or CSS between the surgical approaches.

Conclusions:

• Minimally invasive surgery for localized RCC is linked to an increased risk of local recurrence and uncommon metastases.
• Despite altered recurrence patterns, survival outcomes (DFS, OS, CSS) are similar for both open and minimally invasive approaches.
• The retrospective nature of the study is a primary limitation.