ArticleWorld journal of urology2025
Local recurrence after R0 partial nephrectomy for RCC: insights from a large multicenter cohort (PREPARE study - UroCCR 140).
Article in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeLocal recurrence after partial nephrectomy with negative margins (R0) remains a clinical concern in the management of non-metastatic renal cell carcinoma (RCC). We aimed to quantify its incidence and to identify independent predictors of recurrence in a large, contemporary, multicenter cohort.
methodsWe retrospectively analyzed 2,438 patients from the UroCCR database who underwent R0 nephron-sparing surgery for cT1–cT3a/N0/M0 RCC between 2007 and 2022 across 24 French centers. The primary endpoint was histologically confirmed local recurrence (tumor bed or ipsilateral renal recurrence). Fine‑and‑Gray competing‑risk regression, with death treated as a competing event, was applied to determine independent predictors.
resultsAfter a median follow-up of 66 months (IQR:26–86), local recurrence occurred in 97 patients (3.9%). Independent predictors included open surgery (sHR 2.25 [95% CI, 1.02–4.97]), intraoperative complications (sHR 4.00 [95% CI, 1.65–9.68]), longer delay between diagnosis and surgery (sHR 1.02 [95% CI, 1.003–1.04]), clear cell histology (sHR 4.12 [2.18–7.79]), higher RENAL score, vascular emboli (sHR 3.90 [95% CI, 1.67–9.08]), and tumor necrosis (sHR 2.62 [95% CI, 1.54–4.47]). Robotic assistance was associated with a reduced recurrence risk (sHR 0.50 [95% CI, 0.28–0.88]).
conclusionLocal recurrence after R0 partial nephrectomy, though infrequent, is associated with clinical, surgical, and pathological factors. Open surgery, intra‑operative complications, treatment delay, tumor complexity, vascular emboli, necrosis and clear‑cell histology were correlated with an increase risk of recurrence.
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