Surgical Resection of Isolated Retroperitoneal Lymph Node Recurrence of Renal Cell Carcinoma Following Nephrectomy

Stephen A. Boorjian, Paul L. Crispen, Christine M. Lohse, Bradley C. Leibovich, Michael L. Blute

Research output: Contribution to journalArticle

32 Scopus citations

Abstract

Purpose: Durable survival has been reported following the resection of solitary metachronous metastasis of renal cell carcinoma at sites including the lung, bone and adrenal. We report our experience with resection of isolated retroperitoneal lymph node recurrence. Materials and Methods: Patients who underwent surgical resection of isolated metachronous recurrence of renal cell carcinoma in the retroperitoneal lymph nodes following radical nephrectomy for pTanyNanyM0 tumors were identified (group 1). Progression-free and cancer specific survival were estimated using the Kaplan-Meier method and compared to survival in patients who had pTanyN+M0 disease at nephrectomy (group 2) and in patients who underwent complete resection of a solitary metachronous metastasis at other sites (group 3). Results: A total of 15 patients underwent resection of isolated retroperitoneal lymph node recurrence of renal cell carcinoma. Median time from nephrectomy to resection was 10.3 months (range 3 to 159). No patient received systemic therapy before resection. Recurrence was asymptomatic in all except 1 patient. No intraoperative or postoperative mortality occurred. Six patients subsequently died of renal cell carcinoma at a median of 18 months (range 6 to 33.6) following resection. Median progression-free survival in groups 1 to 3 was 9.1, 8.7 and 15.6 months, while median cancer specific survival was 33.3, 20.8 and 46.9 months, respectively. Conclusions: Resection of isolated retroperitoneal lymph node recurrence may be associated with survival rates approaching those of resection of solitary metastasis at other sites. The decreased time to progression relative to patients with resected metastasis at other sites likely reflects the aggressive biology of nodal disease.

Original languageEnglish (US)
Pages (from-to)99-103
Number of pages5
JournalJournal of Urology
Volume180
Issue number1
DOIs
StatePublished - Jul 1 2008

Keywords

  • carcinoma
  • kidney
  • lymph nodes
  • neoplasm metastasis
  • nephrectomy
  • renal cell

ASJC Scopus subject areas

  • Urology

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