Abstract

Objective: The aim of the current study is to cast further light on the issues related to prognostication of renal cell carcinoma (RCC), assessing the expression of survivin in a subset of primary RCC and determine its relation to different clinicopathological features and disease free survival. Patients and Methods: The present series consisted of tissue samples obtained from 37 Libyan patients with stage I, II, III, or IV RCC. Survivin expression in these tumors was assessed by immunohistochemistry using an automated staining system. Different grading systems were tested for expression of survivin. Results: Expression of survivin was significantly associated with venous invasion (tumor thrombus) (p= 0.042), larger tumor size (p= 0.051), higher primary T classification (p= 0.013), advanced tumor stage (p= 0.033), and borderline association (p= 0.068) with tumor location. In univariate (Kaplan-Meier) survival analysis, survivin expression showed a borderline association (p= 0.089) with disease-free survival (DFS). However, there was no significant correlation between survivin expression and gender, age, histological grade, distance metastasis, lymph node involvement, perinephric fat and capsular invasion, status at end point and recurrence. Conclusion: Survivin expression in RCC may identify patients at risk of a more aggressive disease and a worse prognosis, further investigations, on a larger and more heterogeneous population, should be carried out to validate and extend our results.

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