Association of Extrarenal Invasion Patterns and Tumor Size with the Differences in Survival Outcomes of T3a Renal Cell Carcinoma: A Proposal Modified T3a Stage System is Needed

The purpose of this article was to explore the association of tumor size with lymph node metastases (LNM) risk in patients with clear cell renal cell carcinoma (ccRCC). Based on the Surveillance, Epidemiology, and End Result (SEER) database, patients diagnosed with ccRCC from 1988 to 2015 were included in this study. For each patient, personal characteristics, clinicopathological data, and survival outcomes were, respectively, collected. Subsequently, the odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to investigate the potential risk factors for LNM in ccRCC. Finally, Kaplan-Meier (KM) survival plots of overall survival (OS) and ccRCC-specific survival (CSS) were evaluated on the basis of different tumor sizes. A total of 8,292 patients were finally enrolled in the study, 1,170 of whom (14.11%) had LNM. According to the heatmap, we could intuitively interpret that larger tumor size was related to an increased risk of LNM obviously. The risk of LNM was evidently greater for larger tumor size (4-7 cm: OR = 2.415, 95% CI = 1.708–3.415; 7–10 cm: OR = 3.746, 95% CI = 2.677–5.242; and >10 cm: OR = 4.617, 95% CI = 3.302–6.457) compared with smaller tumor size (≤4 cm). According to the KM survival plots of OS and CSS, we observed a gradual decline in survival with increasing tumor size, while the smallest tumor size had the best survival outcomes. These results indicated the positive relationship of tumor size with risk of LNM in ccRCC. And we also noticed continual decrease survival rates of OS and CSS with increasing tumor size.

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MP72-10 THE PROGNOSTIC IMPLICATION OF BODY MASS INDEX ON POSTOPERATIVE SURVIVAL OUTCOMES IN NON-METASTATIC RENAL CELL CARCINOMA

The Journal of Urology ◽

10.1016/j.juro.2017.02.2246 ◽

2017 ◽

Vol 197 (4S) ◽

Author(s):

Hyung Suk Kim ◽

Chang Wook Jeong ◽

Cheol Kwak ◽

Ja Hyeon Ku ◽

Hyeon Hoe Kim ◽

...

Keyword(s):

Body Mass Index ◽

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Body Mass ◽

Metastatic Renal Cell Carcinoma ◽

Renal Cell ◽

Postoperative Survival ◽

Survival Outcomes ◽

Prognostic Implication

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Sonographic patterns of renal Cell carcinoma with emphasis on relation to tumor size

Journal of Clinical Ultrasound ◽

10.1002/jcu.1870120504 ◽

1984 ◽

Vol 12 (5) ◽

pp. 247-250 ◽

Cited By ~ 4

Author(s):

Sumiko Sugimoto ◽

Fumio Tsujimoto ◽

Yoshinari Kato ◽

Shimpei Tada ◽

Tetsuro Onishi ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Tumor Size ◽

Renal Cell ◽

Sonographic Patterns

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Adrenal metastases: clinical manifestations and surgical outcomes

Cancer Urology ◽

10.17650/1726-9776-2018-14-2-79-87 ◽

2018 ◽

Vol 14 (2) ◽

pp. 79-87 ◽

Cited By ~ 1

Author(s):

V. R. Latypov ◽

O. S. Popov ◽

V. N. Latypova ◽

M. Yu. Grishchenko

Keyword(s):

Lung Cancer ◽

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Tumor Size ◽

Renal Cell ◽

Clinical Manifestations ◽

Adrenal Metastasis ◽

Adrenal Metastases ◽

The Mean ◽

Mean Time

Background. The adrenal glands are one of the most common sites of metastases in malignant disease, particularly lung cancer. The frequency of adrenal metastasis in patients with breast cancer and lung cancer reaches 39 and 35 % respectively.Materials and methods. A total of 156 patients with adrenal tumors underwent surgical treatment in the Siberian State Medical University between December 1998 and July 2017. The study included 16 (10.2 %) patients (9 males and 7 females) with adrenal metastases. The mean age of study participants was 57.6 years (range: 44–73 years).Results. By the moment of surgery, the mean metastatic adrenal tumor size was 4.9 ± 3.0 cm (range: 1.0–10.2 cm). Thirteen out of 16 patients had adrenal metastases from renal cell carcinoma, one patient – from colon cancer, one patient – from lung cancer, and one patient – from breast cancer. Nine patients had left-sided adrenal metastases, whereas six patients had right-sided adrenal metastases. Synchronous adrenal metastasis was detected in two cases: one patient had adrenal metastasis at the side of the renal tumor; the other one had bilateral renal cell carcinoma with both adrenal glands affected.We identified three main variants of the disease course according to prevailing clinical manifestations of adrenal metastasis: no manifestations, pain syndrome, and arterial hypertension.Seven participants had no clinical manifestations; of them, 6 patients had renal cell carcinoma, whereas 1 patient had breast cancer. The mean time between surgical removal of the primary tumor and detection of adrenal metastases was 24.1 months; the mean tumor size was 4.5 cm.Pain syndrome was observed in 5 patients. In three of them, adrenal metastases derived from renal cell carcinoma, in one patient – from lung cancer, and in one patient – from colon cancer. The mean time between removal of the primary tumor and detection of adrenal metastases was 19.8 months; the mean tumor size was 5.4 cm.Arterial hypertension was diagnosed in four patients. The mean time between removal of the primary tumor and identification of adrenal metastases was 27.3 months; the mean tumor size was 4.1 cm. The five-year overall survival rate in operated patient was 47.8 %.Conclusion. Regular examinations of patients after surgical treatment of malignant tumors are needed to detect adrenal metastases; surgery can extend the patient’s life. can extend the patient’s life.

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Tumor-size breakpoint for prognostic stratification of localized renal cell carcinoma

Urology ◽

10.1016/j.urology.2003.09.081 ◽

2004 ◽

Vol 63 (2) ◽

pp. 235-239 ◽

Cited By ~ 32

Author(s):

Vincenzo Ficarra ◽

Tommaso Prayer-Galetti ◽

Giacomo Novara ◽

Emiliano Bratti ◽

Luisa Zanolla ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Tumor Size ◽

Renal Cell ◽

Prognostic Stratification ◽

Localized Renal Cell Carcinoma

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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

Diagnostics ◽

10.3390/diagnostics10030154 ◽

2020 ◽

Vol 10 (3) ◽

pp. 154 ◽

Cited By ~ 2

Author(s):

Takuto Shimizu ◽

Makito Miyake ◽

Shunta Hori ◽

Kota Iida ◽

Kazuki Ichikawa ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Recurrence Rate ◽

Tumor Size ◽

Renal Cell ◽

Renal Vein ◽

Recurrence Rates ◽

Renal Sinus ◽

Collecting System ◽

Urinary Collecting System

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.

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