It’s possible for kidney cancer to come back after a nephrectomy. Having a higher stage or grade of cancer at the time of surgery raises your risk of recurrence. Most recurrences happen within 2 years after surgery.

Surgery is the main type of treatment that’s used for localized kidney cancer. Surgery for kidney cancer involves a nephrectomy, which can remove your entire kidney (radical) or just the cancerous part of your kidney (partial).

While it’s sometimes possible for a nephrectomy to cure kidney cancer, the cancer can also come back. This is called a recurrence.

In this article, we look into the statistics of kidney cancer recurrence after a nephrectomy and what you can do to prevent or reduce your risk of a recurrence.

It’s estimated that about 20% of people who have surgery for localized renal cell carcinoma (RCC) will experience a recurrence of their cancer. RCC is the most common type of kidney cancer, making up about 90% of diagnoses.

Generally speaking, the type of nephrectomy (radical versus partial) you receive doesn’t appear to affect your risk of recurrence. Studies have found that recurrence-free survival and time-to-recurrence are similar between the two procedures.

The two main risk factors involved in the recurrence of kidney cancer after surgery are your cancer’s stage and grade. Having a higher stage, grade, or both raises your risk of kidney cancer coming back.

The stage of a cancer describes how big a tumor is and how far it has spread. There are four different stages of kidney cancer. Higher stages indicate that the cancer is larger, has spread farther, or both.

The grade of a cancer describes how much the cancer cells look like normal cells. There are four grades for kidney cancer. A higher grade means that the cells look more abnormal and are more likely to grow and spread quickly.

Another factor that can increase your likelihood of kidney cancer recurrence is if the surgically removed tumor or cancerous tissue has positive margins, meaning a pathologist sees cancer cells on its edges when viewed under a microscope. Positive margins can indicate that not all the cancer was removed from your body during the surgical procedure.

Can kidney cancer spread after a nephrectomy?

Kidney cancer can spread to more distant areas of your body after a nephrectomy. This is called metastasis. According to the National Cancer Institute (NCI), the most common areas for kidney cancer to spread to are your:

Recurrences of kidney cancer can be either local, metastatic, or both.

A 2020 study found that out of 177 people with an RCC recurrence, 111 had distant (metastatic), 34 had local, and 32 had local and distant.

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After a nephrectomy, a doctor will estimate the risk of your cancer coming back. This typically involves considering the risk factors discussed above.

Your risk level helps to determine how frequently you’ll need to return to a doctor to receive follow-up tests that can help detect a cancer recurrence. These visits typically include:

You may also get treatment with cancer drugs after your nephrectomy in order to reduce the risk of your cancer returning. This is called adjuvant therapy and often lasts for about a year. Examples of drugs that may be used include:

If your kidney cancer has recurred locally after surgery, you may start having signs and symptoms related to your kidneys. These include:

The signs and symptoms of metastatic cancer can vary depending on where the cancer has spread. Some general symptoms of metastatic cancer to be aware of are:

Nephrectomy has the potential to cure kidney cancer. The NCI notes that kidney cancer can often be cured if it remains localized to your kidney and the surrounding tissue. The likelihood of a cure is directly related to your tumor’s stage and grade.

Recurrences typically happen in the years shortly after surgery. For example, a 2019 study points out that 50% of RCC recurrences happen within 2 years after surgery.

Generally speaking, the longer you go without a recurrence, the more likely it is that your kidney cancer is cured. But recurrences can still happen 10 years or more after a nephrectomy.

When a recurrence does happen, there are treatment options available based on where the cancer has recurred. These include additional surgery or targeted therapy drugs, immunotherapy drugs, or a combination of the two.

Cure vs. remission in cancer

Cure: Generally speaking, a cure means that treatment has removed all traces of cancer, no more treatment is needed, and the cancer isn’t expected to return.

Remission: Remission is a period of time when the cancer is responding to treatment or is under control. Depending on the type of cancer, treatment may or may not continue during remission.

Complete remission means there aren’t any detectable signs of cancer. Partial remission means there are far fewer cancer cells, but they may still be detectable.

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It’s possible for kidney cancer to recur after a nephrectomy. Recurrences may be metastatic, localized to your kidneys and the surrounding area, or both. Most recurrences happen in the years shortly after your surgery.

Several factors influence your likelihood of a recurrence. These include your tumor’s grade, stage, and whether or not cancer cells are present in the surgical margins.

If you’ve had a nephrectomy for kidney cancer, it’s important to know your risk of recurrence. Be sure to talk with a healthcare team about your individual recurrence risk and the steps that will be taken to monitor for a recurrence in the coming years.