AI Article Synopsis

  • This study assessed the effectiveness of postoperative radiotherapy in patients with localized renal cell carcinoma (RCC) after radical nephrectomy.
  • A total of 86 patients were analyzed, with varying stages of cancer and most having clear cell carcinomas; they received radiation to the surgical area at a median dose of 46 Gy.
  • The study found that 37% of patients experienced a relapse, with 10-year survival rates of only 40% for disease-free and 42% for overall; thus, postoperative radiation is not recommended due to lack of survival benefit and potential side effects.

Article Abstract

Objective: This study evaluated the results of postoperative adjuvant radiotherapy in patients with localized renal cell carcinoma (RCC).

Patients: Eighty-six patients (median age, 60 years) with RCC treated by radical nephrectomy were evaluated for the efficacy of postoperative radiotherapy. Twenty-four percent of patients had stage T2, 35% T3a, 36% T3b and 5% T4 disease. Seventy-seven percent had clear cell carcinomas and 23% granular cell or spindle and mixed cell carcinomas. Radiotherapy was given to the renal bed and adjacent lymphatic basin at a median dose of 46 Gy.

Results: Thirty-two (37%) patients relapsed: 27 (84%) had systemic relapse only and five (16%) had local and systemic relapse; all patients of the latter group had stage T3b disease. The 10-year disease-free and overall survival was 40% and 42%, respectively. Tumor invasion of the renal vessels and stage of disease were correlated with survival. Side effects of radiotherapy were mainly gastrointestinal, but one patient who received right abdominal irradiation died because of liver failure.

Conclusion: The results of our study are comparable with those reported in the literature. Since postoperative irradiation did not improve the survival of patients with RCC and showed toxicity, it is not recommended.

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http://dx.doi.org/10.1177/030089160208800613DOI Listing

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