1999 PROGNOSTIC ROLE OF TUMOR NECROSIS IN CLEAR CELL RENAL CELL CARCINOMA: RESULTS OF THE SATURN PROJECT

Abstract

You have accessJournal of UrologyKidney Cancer: Advanced1 Apr 20111999 PROGNOSTIC ROLE OF TUMOR NECROSIS IN CLEAR CELL RENAL CELL CARCINOMA: RESULTS OF THE SATURN PROJECT C. Valotto, G. Novara, A. Antonelli, G. Carmignani, S. Cosciani Cunico, N. Longo, G. Martignoni, G. Martorana, A. Minervini, V. Mirone, F. Montorsi, S. Serni, A. Simonato, S. Siracusano, and V. Ficarra C. ValottoC. Valotto Padua, Italy More articles by this author , G. NovaraG. Novara Padua, Italy More articles by this author , A. AntonelliA. Antonelli Brescia, Italy More articles by this author , G. CarmignaniG. Carmignani Genova, Italy More articles by this author , S. Cosciani CunicoS. Cosciani Cunico Brescia, Italy More articles by this author , N. LongoN. Longo Naples, Italy More articles by this author , G. MartignoniG. Martignoni Verona, Italy More articles by this author , G. MartoranaG. Martorana Bologna, Italy More articles by this author , A. MinerviniA. Minervini Florence, Italy More articles by this author , V. MironeV. Mirone Naples, Italy More articles by this author , F. MontorsiF. Montorsi Milan, Italy More articles by this author , S. SerniS. Serni Florence, Italy More articles by this author , A. SimonatoA. Simonato Genova, Italy More articles by this author , S. SiracusanoS. Siracusano Trieste, Italy More articles by this author , and V. FicarraV. Ficarra Padua, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2226AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate the prognostic role of tumor necrosis in a large multi-institutional series of patients undergoing radical or partial nephrectomy for clear cell renal cell carcinoma (RCC). METHODS We collected retrospectively the data of 2719 patients who were surgically treated for clear cell RCC in 16 academic centers involved in the Surveillance And Treatment Update Renal Neoplasms (SATURN) project. Pathological slide review was not performed in these cases. Coagulative tumor necrosis was defined by the presence of homogenous clusters and sheets of degenerating and dead cells. RESULTS Tumor necrosis was present in 578 (21%) patients. At a median follow-up of 40 months (IQR 24–75), 506 patients (19%) had developed disease recurrence and 400 (15%) were dead of RCC. The median follow-up for 2015 (74%) patients who were alive and disease-free at last follow-up was 47 months (IQR 24-83). Five and 10-year cancer-specific survival (CSS) estimates were 89.4% (standard error [SE] 0.8%) and 84% (SE1.4%) in those patients without tumor necrosis, respectively, compared with 58.9% (SE 2.5%) and 45.3% (SE3.4%), respectively, in patients harboring tumor necrosis (log rank p value <0.0001). In univariable analysis, presence of tumor necrosis was significantly associated with CSS (H.R: 4.9; p <0.001). On multivariable Cox regression analyses that adjusted for the effect of for age, gender, symptoms, pT, pN, M stages, and Fuhrman grade, microscopic tumor necrosis was an independent predictor of CSS (H.R. 1.7; p<0.0001). CONCLUSIONS Microscopic tumor necrosis was a strong predictor of CSS in patients with clear cell RCC. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e800 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information C. Valotto Padua, Italy More articles by this author G. Novara Padua, Italy More articles by this author A. Antonelli Brescia, Italy More articles by this author G. Carmignani Genova, Italy More articles by this author S. Cosciani Cunico Brescia, Italy More articles by this author N. Longo Naples, Italy More articles by this author G. Martignoni Verona, Italy More articles by this author G. Martorana Bologna, Italy More articles by this author A. Minervini Florence, Italy More articles by this author V. Mirone Naples, Italy More articles by this author F. Montorsi Milan, Italy More articles by this author S. Serni Florence, Italy More articles by this author A. Simonato Genova, Italy More articles by this author S. Siracusano Trieste, Italy More articles by this author V. Ficarra Padua, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...