Data set for the reporting of carcinoma of renal tubular origin: recommendations from the International Collaboration on Cancer Reporting (ICCR)

Abstract

Aims The International Collaboration on Cancer Reporting (ICCR) has provided detailed data sets based upon the published reporting protocols of the Royal College of Pathologists, the Royal College of Pathologists of Australasia and the College of American Pathologists. Methods and results The data set for carcinomas of renal tubular origin treated by nephrectomy was developed to provide a minimum structured reporting template suitable for international use, and incorporated recommendations from the 2012 Vancouver Consensus Conference of the International Society of Urological Pathology (ISUP) and the fourth edition of the World Health Organisation Bluebook on tumours of the urinary and male genital systems published in 2016. Reporting elements were divided into those, which are required and recommended components of the report. Required elements are: specimen laterality, operative procedure, attached structures, tumour focality, tumour dimension, tumour type, WHO/ISUP grade, sarcomatoid/rhabdoid morphology, tumour necrosis, extent of invasion, lymph node status, surgical margin status, AJCC TNM staging and co‐existing pathology. Recommended reporting elements are: pre‐operative treatment, details of tissue removed for experimental purposes prior to submission, site of tumour(s) block identification key, extent of sarcomatoid and/or rhabdoid component, extent of necrosis, presence of tumour in renal vein wall, lymphovascular invasion and lymph node status (size of largest focus and extranodal extension). Conclusions It is anticipated that the implementation of this data set in routine clinical practice will inform patient treatment as well as provide standardised information relating to outcome prediction. The harmonisation of data reporting should also facilitate international research collaborations.

WHO/ISUP classification, grading and pathological staging of renal cell carcinoma: standards and controversies

“…In addition, the International Committee for Cancer Reporting (ICCR) has devised a series of international datasets for pathologists reporting tumour pathology, with the renal tumour datasets published in 2017 [ 11 , 12 ]. In the UK, the third edition of the Royal College of Pathologists dataset for renal cancer reporting was published in 2017 [ 13 ].…”

The highest Fuhrman and WHO/ISUP grade influences the Ki‐67 labeling index of those of grades 1 and 2 in clear cell renal cell carcinoma

“…Several pathological prognostic factors, such as tumor staging, nuclear grade, tumor necrosis and lymphovascular invasion, are useful for predicting outcomes, and reporting these factors is strongly recommended. 5,6 Most of these factors can be evaluated after radical surgical procedures, such as nephrectomy. Recent advances in sensitive detection methods and devices make the detection of CCRCC possible in the early stages.…”

“…4 Several pathological prognostic factors, such as tumor staging, nuclear grade, tumor necrosis and lymphovascular invasion, are regarded useful for prediction and are recommended for reporting. 5,6 Of note, the nuclear grading system is one of the most reliable and widely used pathological prognostic factors. 7,8 However, prediction of precise clinical behavior, especially when using needle biopsy, remains difficult.…”

The current status of renal cell carcinoma and prostate carcinoma grading

“…In this publication these novel classifications, relating to the two most common morphotypes of RCC and for PCa, were endorsed for international implementation. Subsequently both grading classifications have been incorporated into the reporting datasets issued by the International Collaboration on Cancer Reporting (4, 5).…”

“…While the WHO/ISUP grading system is applicable only to clear cell and papillary RCC it was agreed that it may also be utilized for descriptive purposes for other morphotypes of RCC (4). If grading is applied to morphotypes other than clear cell and papillary RRC, it is recommended that it be clearly stated in the pathology report that grading is provided for descriptive purposes only and that grading has not been validated for any specific type of renal cell neoplasia, other than clear cell and papillary RCC (15).…”