Approximately what percentage of patients can be cured with resection of an isolated local recurrence of RCC, presuming negative surgical margins?

Approximately 20–30% will remain cancer‐free long‐term based on several series in the literature. The remainder have occult micrometastatic disease that will eventually declare itself and lead to patient demise. Risk factors for poor outcomes after resection of local recurrence of RCC were recently defined by Margulis et al, J Urol 2009;181:2044–51. These include positive margins, large recurrent tumor size (>5cm), sarcomatoid features within the local recurrence, and elevated alkaline phosphatase or LDH. Patients with 0, 1, or more than 1 of these risk factors demonstrated median cancer‐specific survival of 111, 40, and 8 months, respectively.

Are there any special concerns related to surgery after TKIs?

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