Clinicopathological Study of Urothelial Carcinoma (UC) of the Renal Pelvis (RP): A Proposal for New pT3 Criteria
T Tsuzuki, N Sassa, M Fukatsu, T Fujita, A Katsuno, T Nishikimi, R Hattori, M Gotoh. Nagoya Daini Red Cross Hopital, Nagoya, Japan; Nagoya University, Nagoya, Japan; Komaki, Komaki Municipal Hospital, Japan; Chyukyo Hospital, Nagoya, Japan; Okazaki Municipal Hospital, Okazaki, Japan
Background: UC of the RP is thought to have a better prognosis than UC of the ureter. UC of the RP is characterized as stage pT3 when the tumor invades beyond the muscularis into the peripelvic fat or renal parenchyma. However, both general pathologists and GU pathologists often have difficulty differentiating parenchymal invasion from ductal spreading in the collecting ducts. Therefore, some cases with ductal spreading but without parenchymal invasion could be misclassified as “pT3”, which may indicate a better prognosis for UC of the RP.
Design: This study consisted of patients who underwent radical nephroureterectomy for UC of the RP. All cases were reviewed without clinical information by one pathologist (T.T.). We classified pT3 cases into the following four groups based on the extent of UC: pT3a, UC extended into the renal medulla; pT3b, UC extended into the renal cortex; pT3b, UC with peripelvic fat invasion; pT3d, pT3a or pT3b cases with UC peripelvic fat invasion. The pT stage and other parameters (tumor necrosis (TN), lymph-vascular invasion (LVI), nuclear grade (1973 WHO) (NG), and presence of CIS) were recorded.
Results: This study included 246 patients (177 males, 69 females; age range 33-94 years, mean 66.7 years). The pT stage and overall 5-year survival (OS) are listed.
|pTa and/or pTis||88||35.6||98.4|