Histopathologic Analysis of Peritumoral Pseudocapsule and Surgical Margin Status after Tumor Enucleation for Renal Cell Carcinoma

Minervini, Andrea; Cristofano, Claudio Di; Lapini, A.; Marchi, Marco; Federico, Lorenzo; Giubilei, Gianluca; Tosi, Nicola; Tuccio, Agostino; Mancini, Massimiliano; Rocca, Carlo Della; Serni, Sergio; Bevilacqua, Generoso; Carini, Marco

doi:10.1016/j.eururo.2008.07.038

Cited by 121 publications

(129 citation statements)

References 32 publications

(58 reference statements)

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“…22 Despite this, multiple studies done by Minervini et al have demonstrated that even a relatively thin pseudocapsule successfully guards against iatrogenic increases in positive margin rates. 11,12 Our data displayed positive surgical margin rates of 3.4% for all cases, with none occurring in the enucleation group. Despite the absence of increased margin rates, we observed the thinnest pseudocapsule in the enucleation group compared with other groups, suggesting that some degree of pseudocapsule may be altered when utilizing this technique.…”

Section: Discussionmentioning

confidence: 56%

“…The integrity of the pseudocapsule may vary greatly depending on the histological features of the tumor it surrounds. 11,23,24 Previous literature has demonstrated that tumor subtype may be predictive of pseudocapsule characteristics. 11,12,24 Additionally, higher rates penetrating pseudocapsule disease in RCC may be seen in patients with of higher Fuhrman grade tumors and more advanced TNM stage.…”

Section: Discussionmentioning

confidence: 99%

“…11,23,24 Previous literature has demonstrated that tumor subtype may be predictive of pseudocapsule characteristics. 11,12,24 Additionally, higher rates penetrating pseudocapsule disease in RCC may be seen in patients with of higher Fuhrman grade tumors and more advanced TNM stage. 6,[8][9][10]23 In the current study, i-Cap scores of 1, 2 and 3 were assigned to 79 (24%), 176 (54%) and 72 (22%) tumors, respectively amongst the entire cohort.…”

Section: Discussionmentioning

confidence: 99%

“…Although several publications have suggested that the presence of a positive margin does not predict tumor recurrence after partial nephrectomy, pathologic invasion of the tumor pseudocapsule may play an important role in predicting cancer recurrence and overall worse outcomes. [8][9][10][11][12] Surgeons have recently purposely enucleated renal tumors at the base of the tumor/parenchymal interface, leading to a new standardization of surgical technique reporting. 5 Currently, there are no protocols for pathologists to use to characterize the integrity of the renal tumor pseudocapsule and the status of the pseudocapsule (presence, absence, invasion into) is not standardly reported to the treating urologist.…”

Section: Introductionmentioning

confidence: 99%

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Standardized Reporting of Microscopic Renal Tumor Margins: Introduction of the Renal Tumor Capsule Invasion Scoring System

et al. 2017

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KEY OF DEFINITIONS FOR ABBREVIATIONS:Renal tumor enucleation allows for maximal parenchymal preservation. Identifying pseudocapsule integrity is critically important in nephron sparing surgery by enucleation. Tumor invasion into and through capsule may have clinical implications although it is not routinely commented on in standard pathologic reporting. We sought to describe a system to standardize the varying degrees of pseudocapsule invasion and to identify predictors of invasion. Materials and Methods:A multicenter retrospective review was carried out between

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Standardized Reporting of Microscopic Renal Tumor Margins: Introduction of the Renal Tumor Capsule Invasion Scoring System

et al. 2017

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“…In these latter cases, when the depth of the lesion or the proximity to important vascular structures makes the procedure more challenging, the adoption of the TE technique can be decisive, as the blunt dissection provides a clear dissection plane identification, helping the surgeon to discriminate the natural cleavage plane existing between the tumor and the renal parenchyma. Moreover, TE provides maximal parenchymal preservation and minimizes incidental calyceal tearing or vascular injuries [32][33][34].…”

mentioning

confidence: 99%

The safety and efficacy of sonidegib for the treatment of locally advanced basal cell carcinoma

Collier

Ali

Lear

2016

Expert Review of Anticancer Therapy

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Differentiating the clinical and computed tomography imaging features of mixed epithelial and stromal tumors of the kidney to establish a treatment plan

Chen

Liu

et al. 2021

J Applied Clin Med Phys

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To differentiate the clinical features and computed tomography imaging features in the two types of mixed epithelial and stromal tumor of the kidney (MESTK) and to establish a treatment plan for the MESTK types. Methods: Seventeen patients who underwent multidetector computed tomography (MDCT) before surgery and had a pathological diagnosis of MESTK were enrolled. Their clinical information (R.E.N.A.L. nephrometry score (R.E.N.A.L.-NS), radical nephrectomy (RN), partial nephrectomy (PN), etc.) were collected. The radiological features included renal sinus fat invagination (SFI), maximal diameter (MD), capsule and septa of the tumor, etc., were also analyzed. They were divided into two types according to the MD solid /MD tumor ratio (solid type with >60%; cystic type with ≤60%). An independent-sample t-test and Fisher exact test were used to assess the differences between the two groups. Results: MESTKs demonstrated a variable multi-septate cystic and solid components with a delayed enhancement. There were nine patients for solid type and eight patients for cystic type. Compared with solid type, the lesions in cystic type have larger MD (81.00 ± 37.91 vs. 41.22 ± 24.19, p = 0.020), higher R.E.N.A.L.-NS (10.03 ± 0.50 vs. 8.95 ± 1.26, p < 0.001), higher RN (75.00% vs. 22.22%, p = 0.015), larger SFI (87.5% vs. 33.3%, p = 0.05), more septa (100% vs. 0%, p < 0.001), and more capsule (100% vs. 11.1%, p < 0.001). Conclusion:Cystic type MESTK has more hazardous features (such as larger MD, higher R.E.N.A.L.-NS, more RN, greater SFI, multiple septa) compared with solid type, suggesting that RN is more suitable for cystic type and PN for solid type. K E Y W O R D Sclassification, clinical data, mixed epithelial and stromal tumor of the kidney, multidetector computed tomography features, patient management INTRODUCTIONMixed epithelial and stromal tumor of the kidney (MESTK), first identified by Michal and Syrucek, 1 is a rare benign entity with a prevalence of 0.2%-1.6% ofThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Histopathologic Analysis of Peritumoral Pseudocapsule and Surgical Margin Status after Tumor Enucleation for Renal Cell Carcinoma

Cited by 121 publications

References 32 publications

Standardized Reporting of Microscopic Renal Tumor Margins: Introduction of the Renal Tumor Capsule Invasion Scoring System

Standardized Reporting of Microscopic Renal Tumor Margins: Introduction of the Renal Tumor Capsule Invasion Scoring System

The safety and efficacy of sonidegib for the treatment of locally advanced basal cell carcinoma

Differentiating the clinical and computed tomography imaging features of mixed epithelial and stromal tumors of the kidney to establish a treatment plan

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