1802 SURGICAL OUTCOME AND PROGNOSTIC FACTOR FOR PT3B RENAL CELL CARCINOMA

Abstract

You have accessJournal of UrologyKidney Cancer: Advanced II1 Apr 20101802 SURGICAL OUTCOME AND PROGNOSTIC FACTOR FOR PT3B RENAL CELL CARCINOMA Jung Kwon Kim, Min Chul Cho, Yong Hyun Park, Seung Baik, Chang Wook Jeong, Ja Hyeon Ku, Cheol Kwak, and Hyeon Hoe Kim Jung Kwon KimJung Kwon Kim More articles by this author , Min Chul ChoMin Chul Cho More articles by this author , Yong Hyun ParkYong Hyun Park More articles by this author , Seung BaikSeung Baik More articles by this author , Chang Wook JeongChang Wook Jeong More articles by this author , Ja Hyeon KuJa Hyeon Ku More articles by this author , Cheol KwakCheol Kwak More articles by this author , and Hyeon Hoe KimHyeon Hoe Kim More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1726AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To analyze the surgical outcome and determine the prognostic factors influencing on survival in patients with pT3b renal cell carcinoma (RCC). METHODS From Feburary 1988 to April 2009, a total of 121 patients with pT3b RCC who underwent radical nephrectomy and thrombectomy were identified. Disease-specific survival (DSS) and overall survival (OS) rates were analyzed retrospectively according to various prognostic factors, including age, gender, body mass index (BMI), clinical symptoms, tumor side (Rt. vs. Lt.), tumor size, thrombus position (renal vein vs. IVC), invasion to perinephric fat or adrenal gland, lymph node involvement, distant metastasis at presentation, histological type of RCC, Fuhrmann nuclear grade, gross tumor necrosis, preoperative American Society of Anesthesiologists (ASA) score. RESULTS There are 84 men (69.4%) and 37 women (30.6%) whose mean age and mean follow-up duration was 56.6 years (range 26 to 78) and 37.3 months (range 1 to 211), respectively. The tumor was right-sided in 50 patients and left-sided in 71 patients. 78 patients (64.5%) presented with clinical symptoms, including palpable mass, gross hematuria, weight loss, flank pain. Of all patients, 96 had level I tumor thrombus, 19 had level II, and 6 had level III tumor thrombus. Of 54 patients who simultaneously received lymph node dissection, 5 had N1 disease and 13 had N2 disease. Histological types of RCC were conventional type in 85, chromophilic type in 7, chromophobic type in 5, collecting duct subtype in 2,unclassified type in 4 and unknown in 18. Sarcomatoid features were present in 9 patients. For Fuhrmann grade, grade 2 was present in 12 patients, 3 in 44, 4 in 23, unknown in 42, respectively. A total of 49 patients died. 5-year DSS and OS rate was 47% and 47%, respectively. On univariate analysis, BMI, presence of clinical symptom, pathological N stage, distant metastasis at presentation, tumor size, invasion to perinephric fat or adrenal gland, gross necrosis, sarcomatoid feature were associated with worse DSS and OS. On multivariate analysis, the presence of clinical symptom, distant metastasis at presentation, gross necrosis, pathological N stage was the independent prognostic factors for both DSS and OS. CONCLUSIONS Our data suggests that the presence of clinical symptom, distant metastasis at presentation, gross necrosis, pathological N stage was the independent prognostic factors for both disease-specific survival and overall survival rate in patients with pT3b RCC. Seoul, Republic of Korea© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e699 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jung Kwon Kim More articles by this author Min Chul Cho More articles by this author Yong Hyun Park More articles by this author Seung Baik More articles by this author Chang Wook Jeong More articles by this author Ja Hyeon Ku More articles by this author Cheol Kwak More articles by this author Hyeon Hoe Kim More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...