Abstract
The optimal cutoff point for evaluating the prognosis of localized renal cell carcinoma (LRCC) remains unclear. This study aimed to verify the efficacy of tumor diameter in the 2010 American Joint Committee on Cancer (AJCC) TNM staging system and contribute to the modification of TNM staging on the prognosis of this disease. A total of 3748 patients with LRCC were enrolled and grouped according to the 2010 AJCC TNM staging system. COX analysis was used to stratify the prognosis. The optimal cutoff point of the tumor diameter in the T1 and T2 prognosis was explored. There were 3330 (88.9%) patients in stage T1 and 418 (11.1%) in stage T2. The cancer-specific mortality rate was 2.7% (100/3748). The mean follow-up was 49.8 months. A tumor diameter of 7 cm can determine the prognosis of patients at stages T1 and T2; however, 4.5 cm and 11 cm as the cutoff points for T1 and T2 sub-classification of patients with LRCC might show better recognition ability than 4 cm and 10 cm, respectively. The 2010 AJCC TNM stage can predict the prognosis of LRCC in stages T1 and T2. In addition, a tumor diameter of 4.5 cm and 11 cm might be the optimal cutoff points for the sub-classification of stages T1 and T2.
Highlights
The optimal cutoff point for evaluating the prognosis of localized renal cell carcinoma remains unclear
In 1987, the tumor diameter cutoff point for LRCC prognosis is first located at 2.5 cm [20]
With the support of follow-up research and a large number of reviews and other evidence-based medicine, 4 cm is further determined as the optimal cutoff point for judging the prognosis of LRCC in T1, which is further divided into T1a and T1b
Summary
The optimal cutoff point for evaluating the prognosis of localized renal cell carcinoma remains unclear. The TNM staging system formulated by the American Joint Committee on Cancer (AJCC) and the International Union Against Cancer is widely applied in the clinical treatment of RCC. In the past 20 years, 7 cm is regarded as the staging cutoff point for T1N0M0 (T1) and T2N0M0 (T2), 4 cm serves as the cutoff point for T1aN0M0 (T1a) and T1bN0M0 (T1b), and 10 cm serves as the cutoff point for T2aN0M0 (T2a) and T2bN0M0 (T2b), which are widely applied in clinical treatment. Clinical studies have found that the optimal cutoff point for evaluating the prognosis of LRCC remains unclear [1, 15]. This study aimed to verify the efficacy of tumor diameter in the 2010 AJCC TNM staging system and put forward modification for TNM staging on the prognosis
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