scholarly journals Small Renal Masses With Tumor Size 0 to 2 cm: A SEER-Based Study and Validation of NCCN Guidelines

2020 ◽  
Vol 18 (10) ◽  
pp. 1340-1347
Author(s):  
Angela Pecoraro ◽  
Giuseppe Rosiello ◽  
Stefano Luzzago ◽  
Marina Deuker ◽  
Franciska Stolzenbach ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Low Grade ◽  
Fuhrman Grade ◽  
Histologic Subtype ◽  
Renal Lesions ◽  
Synchronous Metastases ◽  
Histologic Subtypes

Background: The NCCN Clinical Practice Guidelines in Oncology for Kidney Cancer recommend active surveillance as an option for initial management of T1a 0- to 2-cm renal lesions, in addition to partial nephrectomy, radical nephrectomy, and focal ablation. However, contemporary data regarding the distribution of patient and renal cell carcinoma characteristics within this special patient group are scarce. Methods: Within the SEER database (2002–2016), 13,364 patients with T1aNanyMany 0- to 2-cm renal lesions treated with nephrectomy were identified. Data were tabulated according to histologic subtype, Fuhrman grade (FG1–2 vs FG3–4), age category, and sex. In addition, rates of synchronous metastases were quantified. Results: Overall, clear-cell (69.3%), papillary (21.4%), chromophobe (6.9%), multilocular cystic (2.0%), sarcomatoid dedifferentiation (0.2%), and collecting-duct histologic subtypes (0.2%) were identified. Advanced age was associated with a lower rate of FG1–2 clear cell histologic subtype (70.8%–50.3%) but higher rates of FG1–2 papillary (11.1%–23.9%) and chromophobe histologic subtypes (6.2%–8.5%). Overall, 14.5% individuals harbored FG3–4 clear cell (9.8%) or FG3–4 papillary histologic subtypes (4.8%), and both were more prevalent in men. FG3–4 clear-cell and FG3–4 papillary histologic subtypes increased with age, more so in women than in men. The overall rate of synchronous metastases was 0.4% and ranged from 0 in the multilocular cystic subtype to 0.9% in the FG3–4 papillary histologic subtype, respectively, except for 13.8% in the sarcomatoid dedifferentiation histologic subtype. Conclusions: Most T1a 0- to 2-cm renal cell carcinoma represents the low-grade clear-cell or low-grade papillary histologic subtype, with an FG3–4 minority. Even in patients with the FG3–4 histologic subtype, rates of synchronous metastases are virtually zero.

Prognostic Value of Histologic Subtypes in Renal Cell Carcinoma: A Multicenter Experience

2005 ◽  
Vol 23 (12) ◽  
pp. 2763-2771 ◽  
Author(s):  
Jean-Jacques Patard ◽  
Emmanuelle Leray ◽  
Nathalie Rioux-Leclercq ◽  
Luca Cindolo ◽  
Vincenzo Ficarra ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Multivariate Analysis ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Tnm Stage ◽  
Fuhrman Grade ◽  
Histologic Subtype ◽  
Ecog Ps ◽  
Histologic Subtypes

Purpose To analyze to what extent histologic subtype is of prognostic importance in renal cell carcinoma based on a large, international, multicenter experience. Patients and Methods Four thousand sixty-three patients from eight international centers were included in this retrospective study. Histologic subtype (1997 International Union Against Cancer [UICC] criteria of tumor response), age, sex, TNM stage, Fuhrman grade, tumor size, Eastern Cooperative Oncology Goup performance status (ECOG PS), and overall survival were determined in all cases. The prognostic values of clear cell, papillary, and chromophobe histologic features were assessed by uni- and multivariate analysis using the Kaplan-Meier method and Cox model, respectively. Results Clear cell, papillary, and chromophobe carcinomas accounted for 3,564 (87.7%), 396 (9.7%) and 103 (2.5%) cases, respectively. In univariate analysis, a trend toward a better survival was observed when clear cell, papillary, and chromophobe histologies were considered prognostic categories (log-rank P = .0007). However, in multivariate analysis, TNM stage, Fuhrman grade and ECOG PS, but not histology, were retained as independent prognostic variables (P < .001). Conclusion The stratification in three main renal cell carcinoma histologic subtypes as defined by the 1997 UICC–American Joint Committee on Cancer consensus should not be considered a major prognostic variable comparable to TNM stage, Fuhrman grade and ECOG PS.

Biological significance of serum VEGF measurement in renal cell carcinoma

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 4596-4596
Author(s):  
J. Patard ◽  
N. Rioux-Leclercq ◽  
K. Bensalah ◽  
P. Fergelot
Keyword(s):  
Renal Cell Carcinoma ◽  
Platelet Count ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Renal Tumors ◽  
Enzyme Linked Immunosorbent Assay ◽  
Alkaline Phosphatases ◽  
Fuhrman Grade ◽  
Histologic Subtype

4596 Background: VEGF plays an important role in Renal Cell Carcinoma (RCC) tumor angiogenesis and is a relevant molecular target. Our objective was to correlate serum VEGF measurement to clinical, biological and pathological variables in renal tumors. Methods: 206 patients who were operated for a renal tumor at our institution were prospectively assessed for serum VEGF measurement (enzyme-linked immunosorbent assay, R&D systems). Informed consent was obtained in all cases. Symptoms at presentation, pre-operative biology (haemoglobin, WBC count, platelet count, serum creatinin, calcemia, CRP, ASAT, ALAT, gamma-glutamyltransferase (γGT), Alkaline Phosphatases), TNM stage, Fuhrman grade and final pathology (benign vs malignant histology, histologic subtype) were systematically recorded. Qualitative and quantitative variables were compared by using Chi-square (Fischer exact test) and Student t tests, respectively. Results: There were 128 males (62.1%) and 78 females (37.9%). 185 tumors were malignant at histology (89.8%) including 155 tumors with clear cell histology (83.8%). Median serum VEGF level was 361 ng/ml (41–3090). Mean serum VEGF was not significantly different between benign and malignant tumors as well as between clear cell and non clear cell carcinomas (p: 0.4 and 0.8 respectively). Serum VEGF was strongly associated with symptoms, T Stage (p: 0.0001), N Stage (p: 0.004), Fuhrman grade (p: 0.007) and tumor necrosis (p: 0.004) but not with M Stage (p: 0.3). Serum VEGF was also found to be strongly associated with: haemoglobin, CRP, platelet count (p: 0.0001) and Alkaline phosphatases (p: 0.001). A weaker association was found between serum VEGF and γGT, ASAT (p: 0.05) or ALAT (p: 0.09). Finally serum VEGF was associated with cancer specific survival (p: 0.01). Conclusion: Serum VEGF is strongly associated with most usual clinical, biological and pathological prognostic parameters in RCC. Serum VEGF measurement should be further evaluated for prognostic purpose as well as for treatment monitoring. No significant financial relationships to disclose.

Clinicopathologic Significance of Nuclear Grooves and Inclusions in Renal Cell Carcinoma: Image Database Construction and Quantitative Scoring

2008 ◽  
Vol 132 (6) ◽  
pp. 940-946 ◽  
Author(s):  
Ju-Han Lee ◽  
Eun Mee Han ◽  
Zhen-Hua Lin ◽  
Zheng-Sheng Wu ◽  
Eung-Seok Lee ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Image Database ◽  
Fuhrman Grade ◽  
Histologic Subtype ◽  
Tumor Stages ◽  
Clear Cell Rcc

Abstract Context.—Nuclear grooves and inclusions are major features of cancer. However, the nuclear irregularities in renal cell carcinoma (RCC) have not yet been well characterized. Objective.—To determine the clinicopathologic significance of nuclear grooves and inclusions in RCC. Design.—The frequencies or scores of nuclear grooves and inclusions were compared with the histologic subtype, nuclear grade, and TNM stage, as well as overall survival of RCC patients. For objective counting of nuclear irregularities, a relational image database was constructed and used for quantitative assessment. Results.—Nuclear grooves and inclusions were seen in 96% and 65% of 110 RCC cases, respectively. The intranuclear inclusions were found more frequently in chromophobe and papillary types than in clear cell carcinoma (P &lt; .001). The nuclear scores, the sum of grooves or inclusions per 5000 tumor cells, were highly related to the histologic subtype (P &lt; .001). Clear cell RCCs with high inclusion scores (2 or more) were correlated with poorer overall survival in comparison to clear cell carcinomas with low inclusion scores (P = .04). The groove scores were highly associated with Fuhrman grade (P = .003) but not with overall survival of clear cell RCC patients (P = .65). In multivariate analysis, higher inclusion scores and advanced tumor stages (III/IV) were correlated with worse outcomes of clear cell RCC. Conclusions.—Nuclear grooves and inclusions are histologic components of RCCs, especially chromophobe and papillary carcinomas. Furthermore, nuclear inclusions might be an independent prognostic factor for clear cell RCC.

Clinicopathological features and survival rates of patients with renal cell carcinoma under 50 years of age

Open Medicine ◽  
2008 ◽  
Vol 3 (4) ◽  
pp. 453-458
Author(s):  
Ali Atmaca ◽  
Ömer Bayrak ◽  
Olcay Kandemir ◽  
Ege Şerefoğlu ◽  
Ílke Çulha ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Survival Rates ◽  
Clinicopathological Features ◽  
Fuhrman Grade ◽  
Histologic Subtype ◽  
Presenting Symptoms ◽  
The Mean

AbstractWe analyzed the clinicopathological features and survival rates of the patients with renal cell carcinoma younger than 50 years old. Between 2004 and 2007, 28 patients between 19–49 years underwent surgery for renal cell carcinoma. Presenting symptoms, type of the surgery performed, postoperative outcomes and duration of follow-up were recorded. Mean age was 41.5±7.6 years and 75% of patients were male. The tumor was symptomatic in 19(67.9%) and incidental in 9(32.1%) patients. Radical nephrectomy and nephron-sparing surgery were performed in 18(64.3%) and 10(35.7%) patients, respectively. The most common histologic type was clear cell(67.9%). The mean tumor diameters were 3.5±0.95 and 7.4±5.2 cm in the incidental and symptomatic groups, respectively(p=0.035). Incidentally discovered tumors and tumors treated by NSS did not include Fuhrman grade 4. There were no differences regarding pathological stage and Fuhrman grades when patients were grouped according to their symptomatology(p=0.242 and p=0.265, respectively). Overall mortality was 17.9%(n=5) whereas 4 patients(14.3%) died because of cancer. The mean survival was 30.6 months and cancer specific survival rate was 85.2%. Most of the tumors in this age group were symptomatic and most common histologic subtype was clear cell carcinoma. Incidentally discovered tumors had statistically significant lower tumor size.

scholarly journals Outcomes and prognosticators of stage 4 renal cell carcinoma with pathological T4 primary lesion using a large Canadian multi-institutional database

2019 ◽  
Vol 14 (2) ◽  
Author(s):  
Justin D. Oake ◽  
Premal Patel ◽  
Luke T. Lavallée ◽  
Jean-Baptiste Lattouf ◽  
Olli Saarela ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Cox Regression ◽  
Clear Cell ◽  
Cancer Information ◽  
Study Cohort ◽  
Fuhrman Grade ◽  
Histologic Subtype ◽  
Specific Subset

Introduction: The primary objective of this study was to evaluate outcomes and prognosticators in patients who underwent radical nephrectomy (RN) or cytoreductive nephrectomy (CN), depending on the clinical stage of disease preoperatively, with a pathological T4 (pT4) renal cell carcinoma (RCC) outcome. There is little data on the outcome of this specific subset of patients. Methods: From 2009‒2016, we identified patients in the Canadian Kidney Cancer information system (CKCis) who underwent RN or CN and were found to have pT4 RCC. Clinical, operative, and pathological variables were analyzed with univariable and multivariable Cox proportional hazard models to identify factors associated with overall survival (OS). Survival curves were created using Kaplan-Meier methods and compared using the log-rank test. Results: A total of 82 patients were included in the study cohort. Median patient age was 62 years (interquartile range [IQR] 55, 70). The majority of patients had clear-cell histology, 50 (61%), and 14 (17%) had sarcomatoid characteristics. Median followup was 12 months (IQR 3, 24). At last followup, eight (10%) patients are alive with no evidence of disease, 27 (33%) are alive with disease, four (5%) were lost to followup, 36 (44%) died of disease, and seven (8%) died of other causes. Tumor histologic subtype (clear-cell vs. non-clear-cell) (p=0.0032), larger tumor size (cm) (p=0.012), and Fuhrman grade (G4 vs. G2‒G3) (p=0.045) were significantly associated with mortality in a multivariable Cox regression model. Conclusions: For patients with pT4 RCC after RN or CN, survival is poor. Sarcomatoid features, non-clear-cell histology, and presence of systemic symptoms were associated with worse OS.

scholarly journals Nuclear and cytosolic pS727-STAT3 levels correlate with overall survival of patients affected by clear cell renal cell carcinoma (ccRCC)

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jazmine Arévalo ◽  
David Lorente ◽  
Enrique Trilla ◽  
María Teresa Salcedo ◽  
Juan Morote ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Cell Renal Cell Carcinoma ◽  
Independent Manner ◽  
Fuhrman Grade ◽  
Transcription 3 ◽  
Aggressive Subtype

AbstractClear cell renal cell carcinoma (ccRCC) is the most frequent and aggressive subtype of renal carcinoma. So far, the basis of its oncogenesis remains unclear resulting in a deficiency of usable and reliable biomarkers for its clinical management. Previously, we showed that nuclear expression of the signal transducer and activator of transcription 3 (STAT3), phosphorylated at its serine 727 (pS727), was inversely proportional to the overall survival of ccRCC patients. Therefore, in the present study, we validated the value of pS727-STAT3 as a clinically relevant biomarker in ccRCC. This work is a retrospective study on 82 ccRCC patients treated with nephrectomy and followed-up for 10 years. Immunohistochemical expression of pS727-STAT3 was analyzed on a tissue microarray and nuclear and cytosolic levels were correlated with clinical outcome of patients. Our results showed that pS727-STAT3 levels, whether in the nucleus (p = 0.002; 95% CI 1.004–1.026) or the cytosol (p = 0.040; 95% CI 1.003–1.042), significantly correlate with patients’ survival in an independent-manner of clinicopathological features (Fuhrman grade, risk group, and tumor size). Moreover, we report that patients with high pS727-STAT3 levels who undergone adjuvant therapy exhibited a significant stabilization of the disease (~ 20 months), indicating that pS727-STAT3 can pinpoint a subset of patients susceptible to respond well to treatment. In summary, we demonstrated that high pS727-STAT3 levels (regardless of their cellular location) correlate with low overall survival of ccRCC patients, and we suggested the use of pS727-STAT3 as a prognostic biomarker to select patients for adjuvant treatment to increase their survival.

scholarly journals Obstructive sleep apnea and Fuhrman grade in patients with clear cell renal cell carcinoma treated surgically

2016 ◽  
Vol 35 (1) ◽  
pp. 51-56 ◽  
Author(s):  
Antoni Vilaseca ◽  
Daniel P. Nguyen ◽  
Emily A. Vertosick ◽  
Renato B. Corradi ◽  
Mireia Musquera ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Cell Renal Cell Carcinoma ◽  
Fuhrman Grade ◽  
Obstructive Sleep

CT prediction of the Fuhrman grade of clear cell renal cell carcinoma (RCC): towards the development of computer-assisted diagnostic method

2015 ◽  
Vol 40 (8) ◽  
pp. 3168-3174 ◽  
Author(s):  
Hannu Huhdanpaa ◽  
Darryl Hwang ◽  
Steven Cen ◽  
Brian Quinn ◽  
Megha Nayyar ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Diagnostic Method ◽  
Clear Cell ◽  
Computer Assisted ◽  
Cell Renal Cell Carcinoma ◽  
Fuhrman Grade

scholarly journals Clear Cell Papillary Renal Cell Carcinoma: A Potential Mimic of Conventional Clear Cell Renal Carcinoma on Core Biopsy

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Heath Liddell ◽  
Anton Mare ◽  
Sean Heywood ◽  
Genevieve Bennett ◽  
Hin Fan Chan
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Core Biopsy ◽  
Clear Cell ◽  
Incidental Finding ◽  
Papillary Renal Cell Carcinoma ◽  
Renal Cell Carcinomas ◽  
Fuhrman Grade ◽  
Stage Renal Disease

Clear cell papillary renal cell carcinoma (CCP-RCC) is a recently described, relatively uncommon variant of renal cell carcinoma (RCC) with a reported incidence of 4.1%. Thought to only arise in those with end stage renal disease, CCP-RCC is increasingly identified in those without renal impairment. CCP-RCCs have unique morphologic, genetic, and immunohistochemical features distinguishing them from both conventional clear cell renal cell carcinomas and papillary renal cell carcinomas. Immunohistochemically, these tumors are positive for CK7 and negative for CD10 and racemase. This is in contrast to conventional cell renal cell carcinomas (CK7 negative, CD10 positive) and papillary cell carcinomas (CK7, CD10, and racemase positive). These tumours appear to be indolent in nature, with no current documented cases of metastatic spread. We present the case of a 42-year-old female who presented with an incidental finding of a renal mass that on a core biopsy was reported as clear cell carcinoma, Fuhrman grade 1. She subsequently underwent a radical nephrectomy and further histological examination revealed the tumor to be a clear cell papillary renal cell carcinoma, Fuhrman grade 1.

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