Renal capsular invasion in patients with localized clear-cell renal cell carcinoma (RCC) is associated with an increased risk of cancer recurrence and cancer-related death after surgery, according to researchers at the Catholic University of Korea in Seoul.

They studied 299 patients with localized clear-cell RCC who underwent radical nephrectomy or nephron-sparing surgery. Of the 299 patients, 106 (35.5%) had capsular invasion. These patients had significantly lower five-year recurrence free survival (RFS) and cancer-specific survival (CSS) rates.

After a mean follow-up of 60.5 months, the five-year RFS rate was 77.7% for patients with capsular invasion and 92.3% for subjects without capsular invasion, the investigators reported in European Urology (2009;56:1006-1012). The five-year CSS rate was 85.5% and 95.7%, respectively.

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Capsular invasion independently predicted a threefold increase risk of disease recurrence and a fourfold increased risk of cancer-related death.