MP12-12: Surgical Management and oncologic outcomes for Local Retroperitoneal Recurrence Of Renal Cell Carcinoma After Radical Nephrectomy

Jiwei Huang*, Yueming Wang, Shanghai, China, People's Republic of, Cuijian Zhang, Beijing, China, People's Republic of, Xiaoyi Hu, Shanghai, China, People's Republic of, Ping Wang, Hangzhou, China, People's Republic of, Guohai Shi, Liang Dong, Jin Zhang, Wen Kong, Yonghui Chen, Dingwei Ye, Shanghai, China, People's Republic of, Dan Xia, Hangzhou, China, People's Republic of, Jianming Guo, Wei Xue, Yiran Huang, Shanghai, China, People's Republic of, Zhisong He, Beijing, China, People's Republic of

Introduction: Local retroperitoneal recurrence (RPR) after racial nephrectomy (RN) of renal cell carcinoma (RCC) remains a therapeutic challenge and has a poor prognosis. We assessed the oncological outcomes and prognostic factors of patients with local RPR treated with surgical resection.

Methods: This is a retrospective multi-center study of 182 patients with RPR treated with surgical treatment from 2008 to 2020. Clinical and pathological features, perioperative complications were reported using descriptive statistics. Cancer-specific survival (CSS) was evaluated by Kaplan-Meier method and studied using Cox proportional hazards model.

Results: Median follow-up period was 49 months (95% CI 42.8-55.2) following surgical resection of RPR. No patients had distant metastatic disease at the time of RPR surgery. The median time from RN to RPR was 24 months (IQR 13-48). Metastatic progression was observed in 114 (62.6%) patients after RPR surgery. One, three and five-year CSS rates were 93%, 76% and 69% in these patients, respectively. Neoadjuvant and adjuvant targeted therapy were administered in 24 (13.2%) and 63(34.6%) patients, respectively. In multivariable analysis, mixed type of RPR, maximum diameter of the lesion and the absence of adjuvant targeted therapy were associated with a significantly increased risk of death from RCC.

Conclusions: Surgical resection of RPR after RN offers optimal oncologic outcomes in RCC patients with acceptable complications. Adjuvant targeted therapy could improve the survival outcome in these patients after surgical treatment.

Source of Funding: This study was supported by grants from the Natural Science Foundation of Shanghai (21ZR1438900), Incubating Program for Clinical Research and Innovation of Renji Hospital (PYXJS16-008 and PYIII20-07), and Basic Oncology Research Program from the Bethune Charitable Foundation (BCF-NH-ZL-20201119-024).