Prognostic factors of clear renal cell carcinoma in pT1a cases

Abstract

e16064 Background: The proportion of clear cell renal cell carcinoma (CRCC) cases diagnosed at pT1a is known to be increasing significantly. Although their prognosis is excellent in general, some cases show distant metastasis. Most of proposed prognostic factors are based on mainly large sized CRCC data. The prognostic factors for small sized CRCC, especially for pT1a cases, aren't well described. Methods: Three hundred three pT1a CRCC cases were retrieved from authors’ institution files. All cases were reviewed by the single uropathologist (T. Tsuzuki). For each case, the following pathological parameters were analyzed: patient age, tumor location (upper, middle, low), Furhman grade, presence of capsule, presence of lympho-vascular invasion, growth pattern (expansive or infiltrating), presence of scar, presence of hemorrhage, and presence of necrosis. Results: Male to female ratio was 4.4. Patient's age ranged from 21 to 85 years (median: 59 years). Follow up duration ranged from one to 225 months (median: 59 months). 35 cases showed distant metastasis. The 5-year and 10-year cause specific survival rate were 96.9%, 93.0%. The 5-year and 10-year recurrence free survival rate were 91.8%, 83.9%. Furhman grade (grade 1+2+3 vs. 4), presence of lympho-vascular invasion, infiltrating growth pattern, and presence of necrosis were statistical significant (p < 0.0001). Conclusions: Furhman grade (less than 3 vs. 4), presence of lympho-vascular invasion, growth pattern, and presence of necrosis can be prognostic factors in CRCC in pTa cases. Growth pattern, which is unrecognized concept for prognosis, can be a new prognostic factor in CRCC. No significant financial relationships to disclose.