Prognostic Factors of Clear Renal Cell Carcinoma in pT1a Cases
T Tsuzuki, N Nishikimi, A Katsuno, T Fujita, A Fukatsu, M Araki, N Sasa, Y Yoshino, R Hattori, M Goto. Nagoya Daini Red Cross Hospital, Nagoya, Japan; Okazaki Municipal Hospital, Okazaki, Japan; Chukyo Hospital, Nagoya, Japan; Komaki Municipal Hospital, Komaki, Japan; Toyohashi Municipal Hospital, Toyohashi, Japan; Nagoya University Hospital, Nagoya, Japan
Background: The proportion of clear renal cell carcinoma (CRCC) cases diagnosed at pT1a is known to be increasing significantly. Although their prognosis is excellent in general, some cases show distant metastasis. Most of proposed prognostic factors are based on relatively large sized CRCC data. The prognostic factors for small sized CRCC, pT1a cases aren't well described.
Design: One hundred ninety-eight pT1a CRCC cases were retrieved from authors' institution files. For each case, the following pathological parameters were recorded: patient age, tumor location (upper, middle, low), Furhman grade, presence of capsule, presence of lympho-vascular invasion, growth pattern (expansive or infiltrating), presence of scar, presence of hemorrhage, and presence of necrosis.
Results: Male to female ratio was 4. Patient's age ranged from 21 to 85 years (median 59 years, mean 58.1 years). Follow up duration ranged from one to 265 months (median 62 months). Seventeen cases showed distant metastasis. Furhman grade (grade 1+2+3 vs. 4), presence of lympho-vascular invasion, infiltrating growth pattern, and presence of necrosis were statistical significant (p<0.0001).
Conclusions: Furhman grade (less than 3 vs. 4), presence of lympho-vascular invasion, growth pattern, and presence of necrosis can be prognostic factors in CRCC in pTa cases. Growth pattern may be a new prognostic factor in CRCC.
Category: Genitourinary (including renal tumors)
Tuesday, March 10, 2009 8:30 AM
Platform Session: Section A, Tuesday Morning