Around 20% of people with kidney cancer experience a recurrence of their cancer after a nephrectomy. People with a higher grade or stage of cancer are at a higher risk of recurrence.

Surgery is the most common treatment for kidney cancer. A nephrectomy is a surgical procedure where a surgeon removes all or part of a person’s kidney.

During a radical nephrectomy, a surgeon will remove the entire kidney including the tumor. During a partial nephrectomy, a surgeon will remove the tumor along with some surrounding kidney tissue.

This article discusses the risk of kidney cancer recurrence after a nephrectomy. It also outlines the risk factors for cancer recurrence and whether it is possible to reduce a person’s risk of kidney cancer recurrence after a nephrectomy.

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Studies show that an estimated 20% of people who undergo surgery for localized renal cell carcinoma (RCC), which can include a nephrectomy, may develop a recurrence of kidney cancer. RCC is the most common form of kidney cancer. Around 90% of people with kidney cancer have RCC.

A 2021 study evaluated kidney cancer recurrence after radical and partial nephrectomies. It concluded that the type of nephrectomy did not affect a person’s type of survival.

A 2017 review analyzed the effects of both radical and partial nephrectomies in people with RCC. It concluded there was no difference in the time‐to‐recurrence in people who had undergone either type of nephrectomy. However, the study points out that they only found low-quality evidence to support this.

A 2019 retrospective cohort study states that the higher a person’s kidney cancer T-stage before their nephrectomy, the higher their risk of cancer recurrence.

The T-stage of a person’s cancer refers to the size and extent of a person’s tumor. The higher the T-stage of a person’s cancer, the larger the tumor is.

The study also concluded that the higher the grade of a person’s cancer before their nephrectomy, the higher their risk of cancer recurrence after the procedure.

A tumor grade refers to how abnormal the cancer cells look under a microscope.

Less aggressive cancers have cells that look less abnormal than cells in more aggressive cancers. Less aggressive cancers tend to grow and spread slower than more aggressive cancers.

Diabetes may also increase a person’s risk of recurrence. More research into this is necessary, though.

If a person has a high risk of cancer returning after their surgery, a doctor may recommend treatment with a targeted drug called sunitinib (Sutent).

This drug can help lower a person’s risk of recurrence. A person usually takes this medication for around 1 year after their procedure. This type of treatment is called adjuvant therapy.

Another form of adjuvant therapy for a person with a high risk of cancer recurrence is 1 year of treatment with the immunotherapy drug pembrolizumab.

One 2021 study analyzed the efficacy of pembrolizumab in helping prevent cancer recurrence in people with RCC who had undergone a nephrectomy. All of the participants were at a high risk of cancer recurrence.

During the study, 496 participants received pembrolizumab, and 498 received a placebo. The study concluded that pembrolizumab treatment led to a significant improvement in disease-free survival at 24 months compared to the placebo.

After a nephrectomy, a person may attend regular follow-up appointments. This will allow a doctor to monitor them closely and look for signs of cancer recurrence.

If a person had early stage kidney cancer, their follow-up visits may be once every 12 months for the first few years after treatment. If a person had a later stage kidney cancer, their follow-up appointments may be every 3–6 months for the first 3 years.

During these follow-up visits, a doctor may carry out:

  • imaging tests
  • blood tests
  • a physical examination

If a person’s kidney cancer has recurred and affects the kidneys, a person may experience symptoms of kidney cancer.

Possible symptoms of kidney cancer include:

  • hematuria, or blood in the urine
  • a lump on the side or lower back
  • low back pain on one side
  • loss of appetite
  • unexplained weight loss
  • a persistent fever
  • fatigue
  • anemia

Distant recurrence is when the cancer has returned but is in a different part of the body. The signs and symptoms of distant recurrence can vary depending on the area of the body where the cancer has spread.

A person should contact a doctor as soon as they experience any new symptoms.

Here are some frequently asked questions about kidney cancer and nephrectomies.

Is it common for kidney cancer to come back?

Roughly 20% of people who undergo surgery for RCC develop a recurrence of kidney cancer. RCC is the most common type of kidney cancer.

Does a nephrectomy cure kidney cancer?

If a person discovers their kidney cancer early and it has not spread, a nephrectomy can remove the cancer.

In some people, the cancer may not return. However, others may experience a recurrence of kidney cancer.

During a nephrectomy, a surgeon removes all or part of a person’s kidney. This is a common treatment for kidney cancer.

For some people, their kidney cancer will not return after the procedure. However, others may experience a recurrence of their cancer.

Having a higher stage or grade of kidney cancer before a nephrectomy can increase a person’s risk of cancer recurrence.

If a person is at high risk, their doctor may recommend medication to reduce the risk of recurrence.