Impact of tumor size on the clinical outcomes of patients with Robson Stage I renal cell carcinoma

Kinouchi, Toshiaki; Saiki, Shigeru; Meguro, Norio; Maeda, Osamu; Kuroda, Masao; Usami, Michiyuki; Kotake, Toshihiko

doi:10.1002/(sici)1097-0142(19990201)85:3<689::aid-cncr19>3.0.co;2-7

Cited by 81 publications

(27 citation statements)

References 18 publications

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“…The strong prognostic indication of palpable abdominal mass could be associated with the size of the tumour. Palpable abdominal mass tumours are Other studies have demonstrated that a larger tumour size confers a disadvantage to survival (Kinouchi et al, 1999;Frank et al, 2002). Symptomatic tumours were also associated with a larger mean tumour size in this analysis.…”

Section: Discussionsupporting

confidence: 49%

Clinical Prognostic Factors and Survival Outcome in Renal Cell Carcinoma Patients - A Malaysian Single Centre Perspective

Yap¹,

Ng²,

Ong³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Section: Discussionsupporting

confidence: 49%

Clinical Prognostic Factors and Survival Outcome in Renal Cell Carcinoma Patients - A Malaysian Single Centre Perspective

Yap¹,

Ng²,

Ong³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…42,[76][77][78][79][80] These findings are not surprising as detailed analysis of tumor size as a continuous variable has shown that the probability of death increases with tumor size (3.51 Â for each doubling of tumor size). 81 As a consequence any arbitrary cut point will likely be significantly associated with survival providing that the sample size is sufficiently large.…”

Section: Tumor Size (Tnm Categories T1 and T2)mentioning

confidence: 99%

Advances and controversies in grading and staging of renal cell carcinoma

2009

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Despite the considerable progress made in our understanding of the pathogenesis, genetics, and pathology of renal cell carcinoma (RCC), difficulties remain relating to the prediction of clinical outcome for individual cases. Although there is evidence to show that high-grade tumors have a poorer prognosis when compared to those of low grade, debate remains regarding the predictive value of grading, especially for those tumors classified into the intermediate grades. Numerous composite morphologic and nuclear grading systems have been proposed for RCC and although that of the Fuhrman classification have achieved widespread usage, the validity of the grading criteria of this classification has been questioned. In addition, there are few studies that have attempted to validate the Fuhrman system for RCCs beyond that of the clear cell subtype. Recent studies have indicated that grading of papillary RCC should be based on nucleolar prominence alone and that the components of the Fuhrman grading classification do not provide prognostic information for chromophobe RCC. Independent of tumor grade, the prognostic importance of tumor stage for RCC is well recognized. The Union Internationale Contre le Cancer/American Joint Committee for Cancer Staging and End Results Reporting TNM staging system is now in its sixth edition (2002) and recent refinements have focused on defining size cut points that will identify apparently localized tumors that will develop recurrence and/or metastases despite attempted curative surgery. In parallel with these studies it has been shown that infiltration of the renal sinus is an important prognostic factor, being observed in almost all tumors 47 cm in diameter. Questions remain as to the appropriate stratification of regional extension of RCC, as defined in the T3 tumor-staging category. Recent modifications to this category have been suggested combining the level of infiltration of the venous outflow tract with the presence or absence of infiltration of the adrenal gland and/or perirenal fat. Similarly, the utility of classifying lymph node involvement by tumor is debated, although it is well recognized that lymph node infiltration is associated with a poor prognosis. Although the current TNM classification does provide useful prognostic information it would appear that further modifications are justified to enhance the predictive value of staging for RCC.

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“…25-27 A 5.5-cm breakpoint was indicated in 1999 by Kinouchi et al, 28 who analyzed a series of radical nephrectomies, and more recently by Ficarra et al 29 Ficarra et al investigated a group of 813 patients who had undergone either radical or partial nephrectomies, using the receiver operator characteristic curve analysis to pinpoint the optimal breakpoint, to subclassify organ-confined RCC. The data in this last article were reconfirmed in the current multicenter European study, although different statistical methods were used.…”

Section: Discussionmentioning

confidence: 99%