Local Recurrence After Nephrectomy for Primary Renal Cancer: Computerized Tomography Recognition

Abstract

Local recurrences (15) in 88 patients who had undergone nephrectomy for renal cancer were diagnosed by computerized tomography, with no false positives and 1 false negative. This over-all low rate (17%) probably is owing to the fact that computerized tomography scans were done in patients in good clinical condition. Local recurrence was noted in 3 of 59 asymptomatic patients and in 12 of 19 patients with local symptoms. No recurrence was noted in 10 patients with general symptoms. Twenty percent of local recurrences were asymptomatic and 80% presented with local symptoms. High local recurrence rates were found in cases of transitional cell carcinoma with whole wall involvement or extension to adjacent tissues (4 of 8 patients, 50%), clear cell adenocarcinoma with lymph node involvement (3 of 7 patients, 43%) and partial nephrectomy (3 of 6 patients, 50%). Such patients were at high risk. Apparently, computerized tomography enables earlier, accurate diagnosis of smaller local recurrence in asymptomatic patients and provides a sensitive, reliable, noninvasive, repetitive method of evaluation of clinical treatment trials. Routine followup should be reserved for high risk patients.