大约 20-40% 接受局部疾病治疗的肾癌患者会出现术后复发。存在多种预后模型来帮助临床医生确定远处复发的风险，但这些模型的标准和终点各不相同。我们的目的是检查复发率和临床病理因素作为高危肾细胞癌 (RCC) 患者复发的预测因素。我们对 2000 年 1 月至 2015 年 12 月期间接受肾切除术的 T3 RCC 患者进行了单中心回顾性图表审查. 登记辅助治疗临床试验的患者和随访时间少于三年的患者被排除在外。采用 Kaplan-Meier 生存分析以及单变量和多变量 Cox 回归来确定疾病复发率和预测因素。纳入了 88 名 pT3 RCC 患者，其中 39 名患者出现复发，中位时间为 23.5 个月（范围 1.6-127.5）。 9 名患者在 58 个月后出现疾病复发。 Kaplan-Meier 对数秩检验发现，手术切缘阴性且 Fuhrman 核分级较低的患者具有更高的无复发生存率。单变量 Cox 回归显示手术切缘阳性、高 Fuhrman 核分级和大肿瘤尺寸是重要的预测因素。在多变量 Cox 回归模型中，高 Fuhrman 核分级和阳性手术切缘是复发的显着预测因素。44% 的 T3 期患者出现疾病复发。高福尔曼核分级和阳性手术切缘与复发时间相关。医生应使用预后模型来促进有关疾病复发的对话，并在建议的五年随访期后继续监测高风险患者。我们建议对 pT3 切除患者进行术后长达 10 年的监测。

Approximately 20-40% of kidney cancer patients treated for localized disease experience post-surgical recurrence. Several prognostic models exist to help clinicians determine the risk of distant recurrence, but these models vary in criteria and endpoints. We aimed to examine the recurrence rate and clinicopathologic factors as predictors of recurrence in high-risk renal cell carcinoma (RCC) patients.We conducted a single-center, retrospective chart review of T3 RCC patients who underwent a nephrectomy between January 2000 and December 2015. Patients registered in clinical trials for adjuvant therapy and those with fewer than three years of followup were excluded. Kaplan-Meier survival analysis and univariate and multivariate Cox regression were performed to identify the rate and predictors of disease recurrence.Eighty-eight pT3 RCC patients were included, and 39 patients had recurrence with a median of 23.5 months (range 1.6-127.5). Nine patients had disease recurrence beyond 58 months. Kaplan-Meier log-rank tests identified patients with negative surgical margins and low Fuhrman nuclear grades had greater recurrence-free survival. Univariate Cox regression revealed positive surgical margins, high Fuhrman nuclear grade, and large tumor sizes were significant predictors. In the multivariate Cox regression model, high Fuhrman nuclear grade and positive surgical margins were significant predictors of recurrence.Disease recurrence occurred in 44% of T3-staged patients. High Fuhrman nuclear grade and positive surgical margins were associated with time to recurrence. Physicians should use prognostic models to facilitate conversations about disease recurrence and continue to monitor high-risk patients beyond the recommended five-year followup period. We recommend monitoring pT3 resected patients for up to 10 years post-surgery.