LAUSR

To the Editor We read the article titled ‘Delayed Metastasis of Renal Cell Carcinoma’ with great interest. We agree with the authors that the possibility of delayed recurrence must be considered even a decade following curative treatment of renal cell carcinoma (1). However, while renal cell carcinoma is associated with late recurrence, the phenomenon leading to this entity is not well known (2). Previous studies have shown that predictors of late recurrence are young age at the diagnosis, clear cell histology, absence of sarcomatoid features, and low Fuhrman grade (3). An independent study also stated that risk factors for late recurrence depend on the size of the tumor at diagnosis, stage at the diagnosis, and histopathology (4). For this reason, the American Urological Association and National Comprehensive Cancer Network (NCCN) have laid down specific surveillance protocols as mentioned in our previous correspondence (5).