Urinary Collecting System Invasion Research Articles

Role of clinicopathological variables in predicting recurrence and survival outcomes after surgery for non-metastatic renal cell carcinoma: Systematic review and meta-analysis.

Renal cell carcinoma (RCC) represents 2% of all diagnosed malignancies worldwide, with disease recurrence affecting 20% to 40% of patients. Existing prognostic recurrence models based on clinicopathological features continue to be a subject of controversy. In this meta-analysis, we summarized research findings that explored the correlation between clinicopathological characteristics and post-surgery survival outcomes in non-metastatic RCC patients. Our analysis incorporates 99 publications spanning 140 568 patients. The study's main findings indicate that the following clinicopathological characteristics were associated with unfavorable survival outcomes: T stage, tumor grade, tumor size, lymph node involvement, tumor necrosis, sarcomatoid features, positive surgical margins (PSM), lymphovascular invasion (LVI), early recurrence, constitutional symptoms, poor performance status (PS), low hemoglobin level, high body-mass index (BMI), diabetes mellitus (DM) and hypertension. All of which emerged as predictors for poor recurrence-free survival (RFS) and cancer-specific survival. Clear cell (CC) subtype, urinary collecting system invasion (UCSI), capsular penetration, perinephric fat invasion, renal vein invasion (RVI) and increased C-reactive protein (CRP) were all associated with poor RFS. In contrast, age, sex, tumor laterality, nephrectomy type and approach had no impact on survival outcomes. As part of an additional analysis, we attempted to assess the association between these characteristics and late recurrences (relapses occurring more than 5 years after surgery). Nevertheless, we did not find any prediction capabilities for late disease recurrences among any of the features examined. Our findings highlight the prognostic significance of various clinicopathological characteristics potentially aiding in the identification of high-risk RCC patients and enhancing the development of more precise prediction models.

High XB130 expression in renal cell carcinoma is strongly associated with poor prognosis

The aim of this study was to assess the prognostic value of XB130 expression in three major RCC subtypes, and its association with clinical outcomes and adverse clinicopathologic features. A total of 101 nephrectomy samples at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand, from 2007 to 2017 were included in the study. XB130 immunohistochemistry was performed on slides from a tissue microarray comprised of 71 clear cell RCCs, 23 papillary RCCs, and 7 chromophobe RCCs, and were scored using a Histoscore system on a 0–300 scale. High XB130 expression in clear cell RCC and papillary RCC patients was associated with poor prognosis (log-rank test, P = 0.013, and P = 0.001, respectively). WHO/ISUP grade (P = 0.001) and XB130 high expression (P = 0.019) were found to be independent risk factors for mortality in clear cell RCC using multivariate analysis. The high expression of XB130 in clear cell RCC patients was also associated with high WHO/ISUP grade (P = 0.011), distant metastasis (P = 0.036), TNM stage (P = 0.007), sarcomatoid/rhabdoid differentiation (P = 0.061), and urinary collecting system invasion (P = 0.002). Similarly, high XB130 expression (P = 0.038) was associated with poor prognosis among papillary RCC patients as well as with lymphovascular invasion (P = 0.022), TNM stage (P = 0.030), and sarcomatoid/rhabdoid differentiation (P = 0.044). Overall, our findings showed that high XB130 expression in clear cell RCC and papillary RCC patients are associated with a worse prognosis.

Urinary collecting system invasion on multiphasic CT in renal cell carcinomas: prevalence, characteristics, and clinical significance.

The aim of this study was to determine the prevalence of collecting system invasion (CSI) on multiphasic CT, validate the pathological findings, and investigate the relationship between CSI and clinical outcomes in patients with renal cell carcinomas (RCC). Patients pathologically diagnosed with RCC between January 2008 and December 2017 were retrospectively enrolled in this study. They were divided into two groups according to the presence of CSI on multiphasic CT images. Patients' clinical characteristics, radiological findings, and overall survival (OS) and recurrence-free survival (RFS) rates were analyzed and compared between the groups. In addition, the correlation of radiological findings with pathological findings was investigated. Among the included 347 kidneys of 340 patients, CSI was observed in 11 kidneys (3%; 95% confidence interval, 1.3-5.0%). In all the 11 kidneys, the tumors were pathologically diagnosed as clear cell RCC, and in one kidney, the tumor also had sarcomatoid features. When pathological CSI served as the standard of reference, the sensitivity, specificity, and accuracy of CSI on CT were 50%, 99.7%, and 97.1%, respectively. The OS and RFS rates were not significantly different between patients with CSI on CT and those without CSI. This study found that the prevalence of RCC-related CSI was 3%. Because of the low prevalence, we cannot exclude the possibility that CSI on CT would be associated with the OS and RFS. Further studies are needed to determine whether CSI on CT can be an independent prognostic factor for survival in patients with RCC.

Clinical Significance of Tumor Size, Pathological Invasion Sites Including Urinary Collecting System and Clinically Detected Renal Vein Thrombus as Predictors for Recurrence in pT3a Localized Renal Cell Carcinoma.

The recent eighth tumor-node-metastasis (TMN) staging system classifies renal cell carcinoma (RCC) with perirenal fat invasion (PFI), renal sinus fat invasion (SFI), or renal vein invasion (RVI) as stage pT3a. However, limited data are available on whether these sites have similar prognostic value or recurrence rate. We investigated the recurrence rate based on tumor size, pathological invasion sites including urinary collecting system invasion (UCSI), and clinically detected renal vein thrombus (cd-RVT) with pT3aN0M0 RCC. We retrospectively reviewed 91 patients with pT3aN0M0 RCC who underwent surgical treatment. Patients with tumor size > 7 cm, UCSI, three invasive sites (PFI + SFI + RVI), and cd-RVT showed a significant correlation with high recurrence rates (hazard ration (HR) 2.98, p = 0.013; HR 8.86, p < 0.0001; HR 14.28, p = 0.0008; and HR 4.08, p = 0.0074, respectively). In the multivariate analysis, tumor size of >7 cm, the presence of UCSI, and cd-RVT were the independent predictors of recurrence (HR 3.39, p = 0.043, HR 7.31, p = 0.01, HR 5.06, p = 0.018, respectively). In pT3a RCC, tumor size (7 cm cut-off), UCSI, and cd-RVT may help to provide an early diagnosis of recurrence.

Prognostic effect of renal collecting system invasion on survival of patients with renal cell carcinoma and tumor thrombus.

IntroductionUrinary collecting system invasion (UCSI) has been found to have significant prognostic value for patients with renal cell carcinoma (RCC). However, for RCC patients with venous tumor thrombus (VTT), only contradictory data exist regarding the prognostic efficacy of UCSI. Therefore, the aim of this study is to assess the prognostic relevance of UCSI in survival of patients with RCC and VTT.Material and methodsMedical records in a prospectively maintained institutional database were analyzed for RCC-VTT patients who had undergone nephrectomy with thrombectomy. Then, the effect of UCSI on overall survival was analyzed.ResultsThe study examined data for 114 patients, including patients with VTT present in the renal vein (35 patients, 31%), infrahepatic inferior vena cava (28 patients, 24%), and suprahepatic inferior vena cava (51 patients, 45%). Nineteen percent of patients had UCSI. The median overall survival of patients with UCSI was 9 months, whereas median overall survival was 10 months for patients without collecting system invasion. Survival and regression analyses rejected UCSI as a prognostic marker for overall survival.ConclusionsUCSI has no effect on survival in our cohort of RCC-VTT patients. Therefore, it should not be considered in risk stratification models or in treatment decision-making for this patient group.

Re: Urinary Collecting System Invasion is Associated with Poor Survival in Patients with Clear-Cell Renal Cell Carcinoma.

No AccessJournal of UrologyUrological Survey1 Nov 2017Re: Urinary Collecting System Invasion is Associated with Poor Survival in Patients with Clear-Cell Renal Cell Carcinoma M. Pilar LagunaMD, PhD M. Pilar LagunaM. Pilar Laguna More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.08.025AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail References 1 : AJCC Cancer Staging Manual. New York: Springer International2017. Google Scholar © 2017 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 198Issue 5November 2017Page: 976-978 Advertisement Copyright & Permissions© 2017 by American Urological Association Education and Research, Inc.MetricsAuthor Information M. Pilar Laguna More articles by this author Expand All Advertisement PDF downloadLoading ...

Prognostic Value of Clinical and Pathological Features in Chinese Patients with Chromophobe Renal Cell Carcinoma: A 10-Year Single-Center Study.

Objective: To evaluate the prognostic significance of clinicopathological features in a large series of Chinese patients with chromophobe renal cell carcinoma (RCC).Materials and Methods: Patients with chromophobe RCC who were treated surgically for renal masses at Chinese PLA General Hospital from 2006 to 2015 were identified. Tissue slides were reviewed to verify diagnoses and collect clinicopathological variables. Cox proportional hazard regression models and the Kaplan-Meier method were performed to evaluate the significance of clinicopathological variables on survival outcomes.Results: A total of 209 patients with chromophobe RCC were enrolled in this study. There were only 13 cancer-specific events, which included 7 local recurrences and 6 metastases. The estimated 5-year and 10-year disease-free survival (DFS) rates were 92.4% and 83.1%, respectively. Univariate analysis indicated that tumor size, 2010 AJCC TNM stage, grade, sarcomatoid differentiation and urinary collecting system invasion were correlated with poor DFS. Multivariate analysis revealed that tumor size, 2010 AJCC TNM stage and grade were independent predictors of DFS.Conclusions: According to this long-term follow-up on a large number of Chinese patients, we found that chromophobe RCC was associated with a very low rate of cancer-specific events (6.2%) and has a better prognosis than clear cell RCC. Tumor size, 2010 AJCC TNM stage and grade were independent prognostic factors in Chinese patients with chromophobe RCC. The presence of these features in a nephrectomy specimen with chromophobe RCC warrants more active surveillance.

Urinary collecting system invasion is associated with poor survival in patients with clear-cell renal cell carcinoma.

To evaluate the prognostic significance of urinary collecting system invasion (UCSI) in a large series of patients with clear-cell renal cell carcinoma (RCC). Patients with clear-cell RCC treated with nephrectomy between 2001 and 2010 were reviewed from a prospectively maintained registry. One urological pathologist re-reviewed all slides. Cancer-specific survival was estimated using the Kaplan-Meier method, and associations of UCSI with death from RCC were evaluated using Cox models. Of the 859 patients with clear-cell RCC, 58 (6.8%) had UCSI. At last follow-up, 310 patients had died from RCC at a median of 1.8 years after surgery. The median follow-up for patients alive at last follow-up was 8.2 years. The estimated cancer-specific survival at 10 years after surgery for patients with UCSI was 17%, compared with 60% for patients without UCSI (P < 0.001). In a multivariable model, UCSI remained independently associated with an increased risk of death from RCC (hazard ratio 1.5; P = 0.018). Further, among patients with pT3 RCC, those with USCI had survival outcomes similar to those of patients with pT4 RCC. Collecting system invasion is associated with poor prognosis among patients with clear-cell RCC. If validated, consideration should be given to including UCSI in future staging systems.

Invasion of the urinary collecting system is an independent prognostic factor in pT3 renal cell carcinoma

ObjectiveTo evaluate the prognostic significance of urinary collecting system invasion (UCSI) in pT3 renal cell carcinoma (RCC). Patients and methodsPatients undergoing nephrectomy for renal masses with pathological stage T3 RCC at our institution from 2006 to 2014 were identified. The entire cohort was divided into 2 groups according to the presence of UCSI. Clinicopathological variables were collected and compared using Student’s t-test or chi-square test. Kaplan-Meier survival analysis and multivariate Cox regression were performed to determine the effect of UCSI on survival outcomes. ResultsOf the 218 patients with pT3 RCC enrolled in this study, 68 (31.2%) presented with UCSI. The presence of UCSI was associated with higher rates of symptoms at diagnosis (P<0.001), larger tumor sizes (P = 0.004), higher Fuhrman grades (P = 0.018), lower proportions of perirenal fat invasion (P = 0.024), and higher probabilities of having tumor necrosis (P = 0.024) and positive lymph nodes (P<0.001). When compared with those without UCSI, patients with UCSI showed shorter estimated 5-year cancer-specific survival rates (33.5% vs. 55.8%, P<0.001) and 5-year progression-free survival rates (27.4% vs. 44.3%, P<0.001). Multivariate analysis revealed that UCSI was independently associated with poorer cancer-specific survival rates (hazard ratio = 1.76, 95% CI: 1.12–2.78, P = 0.015) and progression-free survival rates (hazard ratio = 1.82, 95% CI: 1.23–2.68, P = 0.003). ConclusionUCSI appears to be an independent prognostic factor of pT3 RCC and may be considered in future TNM systems to help stratify different prognoses. More attention should be paid to patients with pT3 RCC with UCSI and close follow-up is recommended to improve survival rates.

Prognostic role of urinary collecting system invasion in renal cell carcinoma: a systematic review and meta-analysis.

The relationship between urinary collecting system invasion (UCSI) and oncological outcomes in renal cell carcinoma (RCC) patients has attracted extensive attention recent years. However, the reports were inconsistent and remain controversial. Thus, we performed a systematic literature search of PubMed, Embase, Web of Science and The Cochrane Library databases to identify relevant studies up to June 2015 and conducted a standard meta-analysis of survival outcomes. 17 studies containing 9012 RCC patients satisfied the inclusion criteria. Pooled HRs for overall survival (OS) and recurrence-free survival (RFS) were 1.45 (95% CI, 1.26–1.66, P < 0.001) and 2.27 (95% CI, 1.54–3.34, P < 0.001), respectively. Further subgroup analysis suggested that UCSI was significant associated with poor cancer-specific survival (CSS) in stage T1–T2 RCC (HR = 2.05, 95% CI: 1.43–2.96, P < 0.001) but not in stage T3–T4 tumors (HR = 1.08, 95% CI: 0.63–1.85, P = 0.771). Current evidence revealed that UCSI has a significant negative impact on OS and RFS in RCC patients and could be used to predict CSS especially in localized RCC. Thus, RCC patients with UCSI should be paid more attention by clinician and pathologist and require close follow up for their poor prognosis.

Analysis of clinicopathological features and prognosis in 68 patients with chromophobe renal cell carcinoma

To investigate the clinicopathological features and prognosis of chromophobe renal cell carcinoma (ChRCC). The clinical data of 68 ChRCC cases treated in our department between January 2003 and September 2010 were collected and retrospectively analyzed. The prognostic factors were evaluated by Log-rank test. Kaplan-Meier survival curve was used to estimate the survival rate. Fifty cases were treated with radical nephrectomy and 18 with partial nephrectomy. The mean tumor size was 5.7 cm (1.5 - 16.0 cm). The TNM stages were as follows: pT1aN0M0 in 25, pT1bN0M0 in 22, pT2aN0M0 in 9, pT2bN0M0 in 5, and pT3aN0M0 in 7. According to the Fuhrman grading system, 8 patients were classified as grade I, 42 cases were grade II, 14 cases were grade III, and 4 cases were grade IV. The 3-year and 5-year survival rates were 93.0% and 90.0%, respectively. The log-rank test showed that tumor size (> 7 cm vs. ≤ 7 cm) (P = 0.004), TNM stage (T1-2 vs. T3-4) (P = 0.008) and urinary collecting system invasion (P = 0.024) were associated with survival time. The multivariable Cox regression model revealed that tumor size (> 7 cm vs. ≤ 7 cm) was an independent predictor of aggressive ChRCC (P = 0.038). ChRCC is a distinct type of renal cell carcinoma exhibiting a low degree of malignancy. Most tumors are larger, but predominantly with a favorable prognosis. Fuhrman nuclear grading is not suitable for ChRCC. Tumor size (> 7 cm vs. ≤ 7 cm) is an independent predictor of prognosis of ChRCC.

Urinary Collecting System Invasion Is a Predictor for Overall and Disease-specific Survival in Locally Invasive Renal Cell Carcinoma

To examine the impact of urinary collecting system invasion (UCSI) on survival in patients with pathologic stage T3 renal cell carcinoma (RCC). We identified 1420 patients who underwent nephrectomy at a single institution between 1988 and 2008. Patients with pT3 RCC and data on UCSI were examined (n=303). Clinicopathologic variables were compared using chi-square tests, and a multivariate analysis using the Cox proportional hazards method was used to evaluate the relationship between UCSI and survival. Of 303 patients with pT3 RCC, 67 (22.1%) had UCSI. UCSI was associated with higher T3 substage, tumor size, lymph node metastasis, and sarcomatoid features, as well as a shorter 5-year overall (51.9% vs 30.4%; P=.003) and disease-specific survival (59% vs 33.9%; P<.001) compared with those without USCI. On multivariate analysis, UCSI was independently associated with overall (HR 1.49; 95% CI, 1.02-2.17) and disease-specific survival (HR 1.76; 95% CI, 1.15-2.68). The presence of UCSI is independently associated with higher overall and disease-specific mortality in patients undergoing nephrectomy for pT3 RCC. Locally advanced tumors crossing an additional anatomic boundary into the urinary collecting system appear to represent a particularly aggressive form of disease. These data suggest consideration for including UCSI in the next TNM staging system for RCC.

Hot topics in kidney cancer 2010

The incidence of renal cell carcinoma has increased in recent years, becoming the third most common urologic tumour. This topic issue of the World Journal of Urology provides an updated overview on epidemiology with perspectives on primary prevention by Weikert et al., proceeding from there to an update of imaging and diagnosis by Muller–Lisse. With regard to imaging, it is important for the surgeon to know the reliability of radiological findings in correlation with pathological outcomes. The article by Hong et al. covers this important issue in detail. In some cases with renal lesions of unknown dignity, biopsies are helpful in the preoperative differential diagnosis. In this study by Chyhrai et al., the benefit of multi-colour interphase fluorescence in situ hybridization on fine-needle core biopsies in uncertain renal masses is described. Augmenting prognosis and treatment, Remzi et al. describe the treatment of small renal lesions and possible benign behaviours. Laparoscopic radical nephrectomy is a feasible procedure in treating T1 and T2 tumours and possibly T3 or even more advanced lesions. However, every novel technique has to be evaluated and compared to the standard open procedure in terms of oncological long term outcome. Chen et al. evaluate this question for T1/T2 renal malignancies in a large cohort of patients. Prognostic factors following treatment in localised and advanced disease are of importance, but, unfortunately, the impact and interaction is often unclear. Waalkes et al. demonstrate in a multivariate analysis of a large cohort of patients that the urinary collecting system (UCS) invasion is not an independent prognostic factor in renal cell carcinoma. The treatment of patients with renal cell cancers has evolved substantially during the last decade, mainly due to the introduction of new targeted agents to cure metastatic disease. Less than a decade ago, the progression-free expected survival of patients with metastatic disease was about 3–5 months, with immune therapy. Since the introduction of tyrosine kinase inhibitors, the relapse rate has more than doubled. These important changes in the treatment of advanced renal cancer are discussed in three articles. Finally, Gruschwitz et al. address the role of genetic differentiation for the improvement of histopathological classification of adrenal gland tumours. Nowadays, genetic tests with fine-needle biopsies could be offered in the routine diagnostics of adrenal specimens of unknown origin. We would like to take this opportunity to sincerely thank Professor Dr. Martin Burchardt for inviting us as A. S. Merseburger Department of Urology and Urologic Oncology, Medical School of Hanover [MHH], Carl Neuberg Str. 1, 30625 Hanover, Germany

Urinary collecting system invasion is no independent prognostic factor in renal cell carcinoma

To assess the specific impact of urinary collecting system (UCS) invasion on the long-term prognosis of patients with renal cell carcinoma (RCC). We evaluated 1,678 patients with complete information about UCS invasion of their primary RCC who had undergone renal surgery between 1990 and 2005 in two high volume centers (MH Hannover and Marburg, Germany); the mean follow-up was 5.4 years. Hundred and forty-nine (8.9%) patients demonstrated collecting system invasion. These patients incurred a significant increase in the likelihood of cancer-related death (HR 1.7, 95% CI: 1.4-2.0; P < 0.001), their median 5-year tumor-specific survival rate was 45% as opposed to 73% for patients without UCS invasion (P < 0.001). UCS invasion was significantly associated with tumor stage, grade, lymph node, and visceral metastasis at diagnosis but not with age, gender, histologic subtype, or body mass index. However, using multivariate analysis, UCS invasion disqualified as individual prognostic factor for RCC, neither for localized nor for advanced disease. Facing the results of this large trial, we do not support the inclusion of UCS invasion into upcoming TNM staging systems. In contrast, future research should focus on novel molecular markers expressed by the tumor and/or specific immunological characteristics of patients with RCC which could improve prediction of RCC-associated prognosis.

Commentary on Urinary collecting system invasion is an independent prognostic factor of organ confined renal cell carcinoma: Verhoest G, Avakian R, Bensalah K, Thuret R, Ficarra V, Artibani W, Tostain J, Guille F, Cindolo L, De La Taille A, Abbou CC, Salomon L, Rioux-Leclercq N, Patard JJ, Rennes University Hospital, Rennes, France

Commentary on Urinary collecting system invasion is an independent prognostic factor of organ confined renal cell carcinoma: Verhoest G, Avakian R, Bensalah K, Thuret R, Ficarra V, Artibani W, Tostain J, Guille F, Cindolo L, De La Taille A, Abbou CC, Salomon L, Rioux-Leclercq N, Patard JJ, Rennes University Hospital, Rennes, France

The prognostic value of urinary collecting system invasion

Data from a retrospective multicenter study have revealed that the presence of urinary collecting system invasion portends a worse outcome in patients with organ-confined disease. Evidence that cancer has spread into the collecting system, in the context of other adverse prognostic factors, should prompt clinicians to instigate closer follow-up of patients after nephrectomy.

Urinary collecting system invasion in renal cell carcinoma: Incidence and long‐term prognosis

Current data on the prognostic impact of urinary collecting system (UCS) invasion by renal cell carcinoma (RCC) are highly conflicting. The aim of the present study was to assess incidence and long-term prognosis of RCC patients with and without UCS involvement. We evaluated 780 patients who had undergone renal surgery between 1990 and 2005. The mean follow-up was 5.44 years. Sixty-seven patients (8.6%) demonstrated UCS invasion. These patients had a significant increase in the likelihood of cancer-related death (hazard ratio [HR] 1.9, 95% confidence interval: 1.4-2.7; P = 0.001). Their median 5-year tumor-specific survival rate was 61%, as opposed to 79% for patients without UCS invasion (P = 0.001). UCS invasion was significantly associated with tumor stage, grade, clinical symptoms, lymph node and visceral metastasis at diagnosis, but not with age, gender, histologic subtype or body mass index. However, by means of multivariate analysis, UCS invasion was disqualified as an individual prognostic marker for RCC. We do not advocate the inclusion of UCS invasion into upcoming Tumor-Nodes-Metastasis staging systems. In contrast, future research should focus on the prognostic role of novel molecular tumor markers and/or specific immunological characteristics of RCC patients.

Urinary Collecting System Invasion is an Independent Prognostic Factor of Organ Confined Renal Cell Carcinoma

We evaluated urinary collecting system invasion as a prognostic parameter of renal cell carcinoma. A total of 1,124 patients who underwent nephrectomy for a renal tumor at 5 European centers were included in this retrospective study. Several variables were analyzed including urinary collecting system invasion, age, sex, TNM stage, Fuhrman grade, histological subtype, Eastern Cooperative Oncology Group performance status and cancer specific survival. There were 771 males (68.6%) and 353 females (31.4%) in this study, and median age was 61 years (range 14 to 88). Median tumor size was 6 cm (range 1 to 24). Tumors were organ confined and Fuhrman grade was recorded as 1 or 2 in 67.1% and 62.3% of cases, respectively. Symptoms were present at diagnosis, and Eastern Cooperative Oncology Group performance status was 1 or more in 50.3% and 16.1% of the cases, respectively. Median followup was 43 months (range 1 to 299). At the end of followup 246 patients (21.9%) died of cancer. In 132 cases (11.7%) urinary collecting system invasion was noted. Urinary collecting system invasion was associated with symptoms, TNM stage, Fuhrman grade, tumor size (p <0.001) and Eastern Cooperative Oncology Group performance status (p = 0.003), but not with histological subtype (p = 0.7). On univariate analysis TNM stage, Fuhrman grade, symptoms, Eastern Cooperative Oncology Group performance status, tumor size and urinary collecting system invasion (p = 0.0001) were significant predictors of cancer specific survival. Urinary collecting system invasion was an independent prognostic parameter only in the setting of pT1-T2 tumors. When the urinary collecting system was invaded the 5 and 10-year probabilities of survival were 43% and 41%, respectively. Urinary collecting system invasion appears to be an independent prognostic parameter of organ confined renal cell carcinoma. Our data support the need to integrate this parameter in further TNM revisions.

Urinary collecting system invasion reflects adverse long-term outcome and is associated with simultaneous metastatic spread at the time of surgery and with multilocular dissemination during postsurgical follow-up in renal cell cancer

To assess the prognostic implication of urinary collecting system invasion (CSI) in renal cell cancer (RCC). Surveying a mean follow-up of 85 months, we investigated a cohort of 834 patients after radical (n = 710) or partial (n = 124) nephrectomy. At the time of surgery, 63 patients (7.6%) suffered from metastatic RCC. Various histopathologic parameters were analysed, and cancer specific survival (CSS) curves were individualized for each parameter. Furthermore, multivariate analysis was accomplished. Collecting system invasion was independently associated with a significant decline in CSS and was associated with simultaneous metastatic spread at the time of surgery and multilocular (involvement of at least two different organ systems) dissemination. The prognostic implication of CSI in RCC appears to be more complex than expected. Therefore, pathologists should report on CSI to enable selection of patients to be investigated in prospective studies which are needed to clarify the prognostic role of CSI in RCC.

1290: Prognostic Value of the Urinary Collecting System Invasion in Renal Cell Carcinoma

You have accessJournal of UrologyModerated Poster 39, Tuesday, May 22, 2007, 10:00 am - 12:00 pm1 Apr 20071290: Prognostic Value of the Urinary Collecting System Invasion in Renal Cell Carcinoma Gregory Verhoest, Nathalie Rioux-Leclercq, Karim Bensalah, Francois Guille, Vincenzo Ficarra, Walter Artibani, Jacques Tostain, Luca Cindolo, Alexandre De La Taille, Clément-Claude Abbou, Laurent Salomon, and Jean-Jacques Patard Gregory VerhoestGregory Verhoest More articles by this author , Nathalie Rioux-LeclercqNathalie Rioux-Leclercq More articles by this author , Karim BensalahKarim Bensalah More articles by this author , Francois GuilleFrancois Guille More articles by this author , Vincenzo FicarraVincenzo Ficarra More articles by this author , Walter ArtibaniWalter Artibani More articles by this author , Jacques TostainJacques Tostain More articles by this author , Luca CindoloLuca Cindolo More articles by this author , Alexandre De La TailleAlexandre De La Taille More articles by this author , Clément-Claude AbbouClément-Claude Abbou More articles by this author , Laurent SalomonLaurent Salomon More articles by this author , and Jean-Jacques PatardJean-Jacques Patard More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)31504-0AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "1290: Prognostic Value of the Urinary Collecting System Invasion in Renal Cell Carcinoma." The Journal of Urology, 177(4S), p. 425 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 177Issue 4SApril 2007Page: 425 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Gregory Verhoest More articles by this author Nathalie Rioux-Leclercq More articles by this author Karim Bensalah More articles by this author Francois Guille More articles by this author Vincenzo Ficarra More articles by this author Walter Artibani More articles by this author Jacques Tostain More articles by this author Luca Cindolo More articles by this author Alexandre De La Taille More articles by this author Clément-Claude Abbou More articles by this author Laurent Salomon More articles by this author Jean-Jacques Patard More articles by this author Expand All Advertisement PDF DownloadLoading ...