Abstract
Background The optimal cutoff point for evaluating the prognosis of localized renal cell carcinoma remains unclear. The 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. Methods 3748 patients with localized renal cell carcinoma were enrolled and grouped according to the 2010 AJCC TNM staging system. COX analysis was used to stratify the prognosis and optimal cutoff point of the tumor diameter in the T1 and T2 prognosis was explored. Results 3330 (88.9%) were in stage T1 and 418 (11.1%) were in stage T2. The cancer-specific mortality rate was 2.7% (100/3748). Mean follow-up was 49.8 months. The analysis of tumor diameter at 7 cm can greatly determine the prognosis of patients at stages T1 and T2. However, the tumor diameters of 4.5 and 11 cm set as the cutoff points for T1 and T2 subclassifications of patients with LRCC seemed to have better recognition ability than 4 and 10 cm, respectively. Conclusions The 2010 AJCC TNM stage can greatly predict the prognosis of LRCC in stages T1 and T2. In addition, 4.5 and 11 cm might be optional cutoff points for the tumor diameters for subclassifying stages T1 and T2.
Prognostic factor for Korean patients with renal cell carcinoma and venous tumor thrombus extension: application of the new 2009 TNM staging system