1265 PROGNOSTIC SIGNIFICANCE OF HIGH NUCLEAR GRADE FOR PATIENTS WITH PATHOLOGIC T1A RENAL CELL CARCINOMA

Abstract

You have accessJournal of UrologyKidney Cancer: Localized1 Apr 20111265 PROGNOSTIC SIGNIFICANCE OF HIGH NUCLEAR GRADE FOR PATIENTS WITH PATHOLOGIC T1A RENAL CELL CARCINOMA Kenjiro Suzuki, Ryuichi Mizuno, Shuji Mikami, Kento Kanao, Hidaka Kono, Eiji Kikuchi, Hirohiko Nagata, Hiroshi Asanuma, Akira Miyajima, Ken Nakagawa, and Mototsugu Oya Kenjiro SuzukiKenjiro Suzuki Tokyo, Japan More articles by this author , Ryuichi MizunoRyuichi Mizuno Tokyo, Japan More articles by this author , Shuji MikamiShuji Mikami Tokyo, Japan More articles by this author , Kento KanaoKento Kanao Tokyo, Japan More articles by this author , Hidaka KonoHidaka Kono Tokyo, Japan More articles by this author , Eiji KikuchiEiji Kikuchi Tokyo, Japan More articles by this author , Hirohiko NagataHirohiko Nagata Tokyo, Japan More articles by this author , Hiroshi AsanumaHiroshi Asanuma Tokyo, Japan More articles by this author , Akira MiyajimaAkira Miyajima Tokyo, Japan More articles by this author , Ken NakagawaKen Nakagawa Tokyo, Japan More articles by this author , and Mototsugu OyaMototsugu Oya Tokyo, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.950AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Although the prognosis of patients with pathologic T1a stage renal cell carcinoma (RCC) is generally good, some of these patients show distant metastasis or local recurrence. We investigated the clinicopathological features for predicting disease progression in pathologic T1a RCC. METHODS From March 1996 to September 2009, 186 nephron-sparing surgery and 132 nephrectomy were performed to treat pathologic T1a RCC at our institution. Of the 318 cases, 135 cases were treated with laparoscopic and 183 were treated with open surgery. Bilateral and multiple cases were excluded from the study. Correlations between clinicopathological parameters and disease progression were statistically analyzed. RESULTS Histologically the 318 cases of primary and solitary pathologic T1a RCC included 272 of clear cell (85.5%), 26 of papillary (8.2%), 11 of chromophobe (3.5%), 4 of ACDK (acquired cystic disease of the kidney) (1.3%), 1 of spindle, and 1 of Xp11 translocation RCC. Other 3 cases were unclassified. We identified 11 progressive cases, of which 9 were metastatic cases, 2 were recurrent cases. One patient died of metastatic disease after 34.7 months from the surgery. Laparoscopic surgery group demonstrated similar rates of recurrence-free survival compared with open surgery group. The nephron sparing surgery group showed similar rates of recurrence-free survival compared with nephrectomy group. Univariate analysis showed that high nuclear grade was a significant risk factor of disease progression (p=0.001), however, no significant correlation was found between tumor size, microvascular invasion, or other pathologic factors and disease progression. Multivariate analysis showed that high nuclear grade was a significant factor to predict disease progression (p=0.007). CONCLUSIONS These results imply that high nuclear grade is possibly one of the most important prognostic factors for predicting disease progression after surgery in pathologic T1a RCC. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e505-e506 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kenjiro Suzuki Tokyo, Japan More articles by this author Ryuichi Mizuno Tokyo, Japan More articles by this author Shuji Mikami Tokyo, Japan More articles by this author Kento Kanao Tokyo, Japan More articles by this author Hidaka Kono Tokyo, Japan More articles by this author Eiji Kikuchi Tokyo, Japan More articles by this author Hirohiko Nagata Tokyo, Japan More articles by this author Hiroshi Asanuma Tokyo, Japan More articles by this author Akira Miyajima Tokyo, Japan More articles by this author Ken Nakagawa Tokyo, Japan More articles by this author Mototsugu Oya Tokyo, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...