Meta-analysis of clinicopathologic predictors of recurrence and survival outcomes after surgery for non-metastatic renal cell carcinoma

Prof. Sharokh Shariat

Among patients with non-metastatic renal cell carcinoma (nmRCC), recurrence is seen in 20% to 40% of patients. There is no consensus on predictors of recurrence and survival outcomes. Systematic review and meta-analysis of 99 studies (140,568 patients) found that T stage, tumor grade, tumor size, lymph node involvement, tumor necrosis, sarcomatoid features, positive surgical margins, lymphovascular invasion, early recurrence, constitutional symptoms, poor performance status, low hemoglobin level, high body mass index, diabetes mellitus, and hypertension were predictors of poor recurrence-free survival and cancer-specific survival. Clear cell subtype, urinary collecting system invasion, capsular penetration, renal vein invasion, and increased CRP were associated with poor recurrence-free survival. Age, sex, tumor laterality, and nephrectomy type had no impact on survival outcomes. The authors conclude that these findings highlight the prognostic significance of various clinicopathologic factors in nmRCC.