1244 TUMOR NECROSIS AFFECT PATIENTS SURVIVAL IN NON METASTATIC RENAL CELL CARCINOMA

Abstract

You have accessJournal of UrologyKidney Cancer: Localized III1 Apr 20101244 TUMOR NECROSIS AFFECT PATIENTS SURVIVAL IN NON METASTATIC RENAL CELL CARCINOMA Marco Roscigno, Richard Zigeuner, Elena Strada, Giovanni Petralia, Francesco Sozzi, Alberto Briganti, Andrea Gallina, Massimo Freschi, Pierre Karakiewicz, Luigi Da Pozzo, Francesco Montorsi, Patrizio Rigatti, and Roberto Bertini Marco RoscignoMarco Roscigno Milan, Italy More articles by this author , Richard ZigeunerRichard Zigeuner Graz, Austria More articles by this author , Elena StradaElena Strada Milan, Italy More articles by this author , Giovanni PetraliaGiovanni Petralia Milan, Italy More articles by this author , Francesco SozziFrancesco Sozzi Milan, Italy More articles by this author , Alberto BrigantiAlberto Briganti Milan, Italy More articles by this author , Andrea GallinaAndrea Gallina Milan, Italy More articles by this author , Massimo FreschiMassimo Freschi Milan, Italy More articles by this author , Pierre KarakiewiczPierre Karakiewicz Montreal, Canada More articles by this author , Luigi Da PozzoLuigi Da Pozzo Bergamo, Italy More articles by this author , Francesco MontorsiFrancesco Montorsi Milan, Italy More articles by this author , Patrizio RigattiPatrizio Rigatti Milan, Italy More articles by this author , and Roberto BertiniRoberto Bertini Milan, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.788AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The prognostic role of tumor necrosis in renal cell carcinoma (RCC) is still under debate. We aimed to evaluate whether tumor necrosis may affect cancer-specific mortality (CSM) in patients with RCC METHODS We retrospectively analyzed data of 1085 consecutive patients who underwent radical nephrectomy or nephron-sparing surgery for RCC, between 1987 and 2007. The Kaplan-Meier method and univariable and multivariable Cox regression analyses were used to determine the effect of predictors on CSM. Covariates consisted of TNM stage, Fuhrman grade, tumor size, symptom classification, and tumor necrosis. The analysis first addressed the entire patients population (n = 1085) and then was repeated in patients with only non metastatic disease. RESULTS Median follow-up was 60 months (2-254). Patient characteristics: median age 61 yrs (range 24-91), pT1a/pT1b/pT2/pT3a/pT3b/pT3c/pT4 (TNM 2002): 362/253/134/157/149/16/14, pN0-pNx/pN+ 1004/81; G1/G2/G3/G4 174/576/270/65; M0/M+ 908/177. Tumor necrosis was present in 401 patients (37.8%). In the overall population, tumor necrosis was associated with worse 5-year survival than patients without tumor necrosis (57% vs 90%; log-rank p>0.001). Nonetheless, tumor necrosis did not achieve the independent predictor status of CSM at multivariable Cox regression analysis, after adjusting for the above mentioned clinical and pathologic variables (p=0.22). In the subgroup of nonmetastatic (pNx-0 M0) patients, tumor necrosis was associated with worse 5-year survival (79% vs 95%; p<0.001) and was also independent predictor of higher risk of CSM at multivariable Cox regression analysis (p=0.44; HR:1.7), together with pT stage (p<0.001) and tumor size (p<0.05). CONCLUSIONS Tumor necrosis seems to be associated with a higher risk of CSM in nonmetastatic RCC population. In the presence of metastatic disease, tumor necrosis does not affect patients outcomes. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e481 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Marco Roscigno Milan, Italy More articles by this author Richard Zigeuner Graz, Austria More articles by this author Elena Strada Milan, Italy More articles by this author Giovanni Petralia Milan, Italy More articles by this author Francesco Sozzi Milan, Italy More articles by this author Alberto Briganti Milan, Italy More articles by this author Andrea Gallina Milan, Italy More articles by this author Massimo Freschi Milan, Italy More articles by this author Pierre Karakiewicz Montreal, Canada More articles by this author Luigi Da Pozzo Bergamo, Italy More articles by this author Francesco Montorsi Milan, Italy More articles by this author Patrizio Rigatti Milan, Italy More articles by this author Roberto Bertini Milan, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...