Work

Tumor hilar proximity may be predictive of recurrence, survival, stage, and grade in patients with renal cell carcinoma

Year: 2026

Type: article

Abstract: Introduction Recurrence after nephrectomy for localized renal cell carcinoma (RCC) occurs in up to 30% of patients. This study's aims were twofold: (1) to evaluate whether hilar proximity is associated with disease recurrence, cancer-specific survival (CSS), and overall survival (OS) as a preoperative variable; and (2) to determine whether it correlates with adverse pathological features such as stage and grade. Methods The Emory Nephrectomy database was reviewed, including patients ≥18 years with non-metastatic RCC (T1–4N0M0) undergoing radical nephrectomy from 2000–2022, with ≥36 months follow-up. Tumor-to-hilum distance was classified as proximal (<1cm) or peripheral (≥1cm). Outcomes included 3-year disease-free survival (DFS), CSS, OS, pathological stage, and grade. Multivariable Cox proportional hazards and logistic regression models adjusted for clinicodemographic variables. Results Among 837 patients, proximal tumors were independently associated with increased recurrence within 3 years (HR 1.86, 95%CI 1.34–2.58, p<0.001) and reduced CSS (HR 2.04, 95%CI 1.28–3.26, p=0.003), without a significant association with OS. Proximal tumors also carried higher odds of pathological stage T3–4 (OR 7.48, 95%CI 5.13–10.91, p<0.001) and Fuhrman grade 3–4 (OR 2.04, 95%CI 1.43–2.91, p<0.001) Conclusions Tumor proximity to the renal hilum was discovered to be associated with higher recurrence risk, reduced CSS, and adverse pathological features. Hilar proximity may serve as both a marker and driver of aggressive disease, warranting incorporation into risk stratification models and surveillance strategies.

Source: Surgical Oncology Insight

DOI: 10.1016/j.soi.2026.100244