Surgical margin does not influence recurrence rate in pT1 clear cell renal cell carcinoma after partial nephrectomy: A multicenter study

654 Background: We investigated correlation of their pathological findings and their prognostic factors in non-clear cell renal cell carcinoma (ncRCC) diagnosed by both regional pathology (RP) and central pathology (CP) in multicenter study. Methods: In January 2005 to December 2014, 140 cases of ncRCC diagnosed by radical or partial nephrectomy were assessed. We assessed their pathological diagnosis by one central pathologist using the 2016 WHO classification tumor of the kidney. We assessed the correlation between clinical parameters or pathological findings and their prognosis. Then, we performed immunohistochemical analysis using PD-1 related antibody in ncRCC. Results: Median follow up was 32.7 months (1-134). Median age was 66 years, 99 males and 41 females. Pathological stage was pT1a: 58, pT1b: 30, pT2a: 17, pT2b: 6, pT3a: 21, pT3b: 2, pT4: 3 cases, respectively. In RP, histology was papillary (PAP): 60 (42.9%), chromophobe (CHR): 49 (35.0%), containing with sarcomatoid components (SAR): 14 (10.0%) and other histology: 17 (12.1%) cases, respectively. The tumors evaluable by CP were 127 cases, PAP: 52 (40.9%), CHR: 31 (24.4%), SAR: 20 (15.7%) and other histology: 24 cases (18.8%), respectively. The overall concordance rate was 59.5% between RP and CP. In multivariate analysis, SAR was extremely poor prognosis in ncRCC. The high neutrophil lymphocyte ratio (NLR) and at high CRP value were also poor prognostic factors. So, we stratified three risk groups using three factors, namely NLR, CRP and SAR. In overall survival, there were significant prognostic differences within three groups (p = 0.0014). In immunohistochemistry, PD-1 or PD-L1 expression correlated with poor overall, cancer specific and recurrence free survival in ncRCC. In multivariate analysis, PD-L1 expression was most significant prognostic factor for ncRCC. Conclusions: These results suggest that Risk stratification by three risk factors is useful prognostic model and the expression of PD-1 and PD-L1 may be a useful prognostic factor in ncRCC.

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Partial Nephrectomy For a Presumed Single Renal Mass Revealing Multiple Tumor Histologies: A Series of 4 Patients

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqaa161.132 ◽

2020 ◽

Vol 154 (Supplement_1) ◽

pp. S61-S61

Author(s):

S Arora ◽

C G Rogers ◽

K Arora ◽

R Abou Shaar ◽

B Kezlarian ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Partial Nephrectomy ◽

Renal Cell ◽

Renal Mass ◽

Clear Cell ◽

Papillary Renal Cell Carcinoma ◽

Chromophobe Renal Cell Carcinoma ◽

Cell Renal Cell Carcinoma ◽

Renal Mass Biopsy

Abstract Introduction/Objective Renal mass biopsy is known to have a low but unavoidable diagnostic error rate. However, the occurrence of multiple adjacent masses mimicking one mass clinically has been minimally studied. Methods We report a series of four patients who were radiologically presumed to have a single renal mass and treated with partial nephrectomy, yet who were found to have multiple demarcated renal cell carcinoma histologies at pathologic evaluation. Results All were men aged 63–70 years. Grossly, tumors were red brown with scant, bright yellow foci in one of them. Dominant tumors followed by smaller tumors were: patient 1 - clear cell renal cell carcinoma (5.0 cm), clear cell papillary renal cell carcinoma (0.5 cm), and papillary adenoma (0.6 cm); patient 2 - clear cell renal cell carcinoma (1.5 cm) and clear cell papillary renal cell carcinoma (0.5 cm); patient 3 - papillary renal cell carcinoma (5.0 cm) and eosinophilic variant of chromophobe renal cell carcinoma (1.0 cm); patient 4 - chromophobe renal cell carcinoma (4.0 cm) and clear cell papillary renal cell carcinoma (0.6 cm). Immunohistochemical studies for cytokeratin 7, carbonic anhydrase IX, high molecular weight cytokeratin, CD10, and alpha-methyl acyl-CoA racemase (AMACR) confirmed the separate components in all. Conclusion This series adds to the spectrum of causes that may contribute to discordant results of renal mass biopsy and resection specimens. Secondary smaller tumors appear to be predominantly nonaggressive histologies, enriched for clear cell papillary renal cell carcinoma. Pathologists and urologists should be aware of this occurrence when considering the role of renal mass biopsy and interpreting the results.

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Histologic subtype needs to be considered after partial nephrectomy in patients with pathologic T1a renal cell carcinoma: papillary vs. clear cell renal cell carcinoma

Journal of Cancer Research and Clinical Oncology ◽

10.1007/s00432-017-2430-6 ◽

2017 ◽

Vol 143 (9) ◽

pp. 1845-1851 ◽

Cited By ~ 7

Author(s):

Sangjun Yoo ◽

Dalsan You ◽

In Gab Jeong ◽

Cheryn Song ◽

Bumsik Hong ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Partial Nephrectomy ◽

Renal Cell ◽

Clear Cell ◽

Cell Renal Cell Carcinoma ◽

Histologic Subtype

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Renal Cell Carcinoma in a Horseshoe Kidney Treated with Laparoscopic Partial Nephrectomy

Case Reports in Oncological Medicine ◽

10.1155/2018/7135180 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3 ◽

Cited By ~ 3

Author(s):

Shinji Ohtake ◽

Takashi Kawahara ◽

Go Noguchi ◽

Noboru Nakaigawa ◽

Kimio Chiba ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Partial Nephrectomy ◽

Renal Cell ◽

Surgical Margin ◽

Horseshoe Kidney ◽

Anatomical Variations ◽

Laparoscopic Partial Nephrectomy ◽

Preoperative Imaging ◽

Cell Renal Cell Carcinoma

Introduction. Horseshoe kidney is one of the most common congenital renal fusion anomalies. Due to its poor mobility and abnormal vasculature form, surgeons should pay close attention to all anatomical variations. Case Presentation. An 83-year-old woman was referred to our hospital because of left renal tumor in a horseshoe kidney incidentally found by her previous hospital. We performed laparoscopic partial nephrectomy. The pathological diagnosis was clear cell renal cell carcinoma. G2 INFα V-pT1a with a negative surgical margin. No evidence of recurrence has been noted, and the renal function is well preserved at 28 months after surgery. Conclusion. When performing laparoscopic partial nephrectomy for renal carcinoma, especially a horseshoe kidney, preoperative imaging is crucial for identifying the location of the renal vessels.

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Impact of Laparoscopic Partial Nephrectomy and Open Partial Nephrectomy on Outcomes of Clear Cell Renal Cell Carcinoma

Frontiers in Surgery ◽

10.3389/fsurg.2021.681835 ◽

2021 ◽

Vol 8 ◽

Author(s):

Feng Yu ◽

Qian Xu ◽

Xian-Gen Liu

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Partial Nephrectomy ◽

Renal Cell ◽

Clear Cell ◽

Laparoscopic Partial Nephrectomy ◽

Inflammatory Factors ◽

Cell Renal Cell Carcinoma ◽

Open Partial Nephrectomy ◽

The Impact

Objective: To analyze the impact of laparoscopic partial nephrectomy (LPN) and open partial nephrectomy (OPN) on outcomes of complex clear cell renal cell carcinoma (ccRCC).Methods: A total of 132 high-complex ccRCC patients with a Radius Exophytic Nearness Anterior Location (R.E.N.A.L) score ≥7 enrolled in our hospital between January 2018 and June 2020 were matched and assigned to an LPN group (given LPN treatment) and an OPN group (given OPN treatment), with 66 cases in each group. Two weeks and 3 months after the operation, the renal indexes, inflammatory factors, basic perioperative conditions, and incidence of complications were compared.Results: Two weeks after the operation, the levels of SCr and CysC were elevated, with higher levels observed in the LPN group (all P < 0.05), and the eGFR levels were reduced, with a lower result in the LPN group. Three months after the operation, the two groups observed decreased levels of SCr and CysC, and an increased level of eGFR; moreover, the decreased SCr and CysC levels were still higher, and the increased eGFR was lower than those before the operation (P < 0.05). The levels of CRP and TNF-α in the two groups increased after the operation, with a lower outcome in the LPN group (P < 0.05). Moreover, the LPN group had less intraoperative blood loss and shorter postoperative length of hospital stay but longer blocking time compared to the OPN group (P < 0.05). Patients in the LPN group were recorded with a lower complication incidence compared with the OPN group (3.03 vs. 15.15%, P < 0.05).Conclusion: Both LPN and OPN enjoy significant efficacy in the treatment of complex ccRCC and effectively protect renal function. Moreover, LPN is a more acceptable option for complex ccRCC due to its numerous benefits in postoperative stress response, complications, recovery. which is worthy of promotion with safety and feasibility.

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