Independent Validation of the 2010 American Joint Committee on Cancer TNM Classification for Renal Cell Carcinoma: Results From a Large, Single Institution Cohort

Kim, Simon P.; Alt, Angela L.; Weight, Christopher J.; Costello, Brian A.; Cheville, John C.; Lohse, Christine M.; Allmer, Cristine; Leibovich, Bradley C.

doi:10.1016/j.juro.2011.02.059

Cited by 127 publications

(105 citation statements)

References 22 publications

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“…The prognostic value of the 2010 TNM classification has been validated in both single-and multiinstitutional studies [37]. However, the subclassification of T1 tumours using a cutoff of 4 cm might not be optimal with the widening indication for nephron-sparing surgery for localised RCC.…”

Section: Tnm Stage Classificationmentioning

confidence: 99%

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EAU Guidelines on Renal Cell Carcinoma: The 2010 Update

Ljungberg¹,

Cowan²,

Hanbury³

et al. 2010

European Urology

1,331

1,008

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Context: The European Association of Urology Guideline Panel for Renal Cell Carcinoma (RCC) has prepared evidence-based guidelines and recommendations for RCC management. Objectives: To provide an update of the 2010 RCC guideline based on a standardised methodology that is robust, transparent, reproducible, and reliable. Evidence acquisition: For the 2014 update, the panel prioritised the following topics: percutaneous biopsy of renal masses, treatment of localised RCC (including surgical and nonsurgical management), lymph node dissection, management of venous thrombus, systemic therapy, and local treatment of metastases, for which evidence synthesis was undertaken based on systematic reviews adhering to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Relevant databases (Medline, Cochrane Library, trial registries, conference proceedings) were searched (January 2000 to November 2013) including randomised controlled trials (RCTs) and retrospective or controlled studies with a comparator arm. Risk of bias (RoB) assessment and qualitative and quantitative synthesis of the evidence were performed. The remaining sections of the document were updated following a structured literature assessment. Evidence synthesis: All chapters of the RCC guideline were updated. For the various systematic reviews, the search identified a total of 10 862 articles. A total of 151 studies reporting on 78 792 patients were eligible for inclusion; where applicable, data from RCTs were included and meta-analyses were performed. For RCTs, there was low RoB across studies; however, clinical and methodological heterogeneity prevented data pooling for most studies. The majority of studies included were retrospective with matched or unmatched cohorts based on single or multi-institutional data or national registries. The exception was for systemic treatment of metastatic RCC, in which several RCTs have been performed, resulting in recommendations based on higher levels of evidence.

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Section: Tnm Stage Classificationmentioning

confidence: 99%

“…In comparison to the 2009 version, there is no longer any distinction between N1 metastasis in a single regional lymph node and N2 metastases in more than one regional lymph node. Instead, N1 comprises metastasis in regional lymph node(s) [37].…”

Section: Tnm Stage Classificationmentioning

confidence: 99%

EAU Guidelines on Renal Cell Carcinoma: The 2010 Update

Ljungberg¹,

Cowan²,

Hanbury³

et al. 2010

European Urology

1,331

1,008

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“…The improvements evidenced by this reclassification came about mainly as a consequence of the inclusion of adrenal invasion, a strong adverse prognostic factor, in the T4 disease category. In previous studies, both Novara et al 5 and Kim et al 11 showed that there was a significantly different survival rate between the T3a and T3b subgroups according to the revised 2010 staging system. Kaplan-Meier plots showed a significant difference in survival between the T3a and T3b subgroups (log-rank, P50.03), indicating that the 2010 TNM staging system could accurately distinguish survival between T3a and T3b tumours.…”

Section: Discussionmentioning

confidence: 94%

Application of the revised Tumour Node Metastasis (TNM) staging system of clear cell renal cell carcinoma in eastern China: advantages and limitations

Qin¹,

Sun²,

Cui³

et al. 2013

Asian J Androl

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This study was designed to evaluate whether the revised 2010 Tumour Node Metastasis (TNM) staging system could lead to a more accurate prediction of the prognosis of renal cell carcinoma (RCC) patients. A total of 1216 patients who had undergone radical nephrectomy or partial nephrectomy for RCC from 2003 to 2011 were enrolled. All of the patients had pathologically confirmed clear cell RCC (ccRCC). All cases were staged by both the 2002 and 2010 TNM staging systems after pathological review, and survival data were collected. Univariate and multivariate Cox regression models were used to evaluate cancer-specific survival (CSS) and progression-free survival (PFS) after surgery. Continuous variables, such as age and tumour diameter, were calculated as mean values and standard deviations (s.d.) or as median values. Survival was calculated by the Kaplan-Meier method, and the log-rank test assessed differences between groups. Statistically significant differences in CSS and PFS were noted among patients in T3 subgroups using the new 2010 staging system. Therefore, the revised 2010 TNM staging system can lead to a more accurate prediction of the prognosis of ccRCC patients. However, when using the revised 2010 staging system, we found that more than 92% of patients (288/313) with T3 tumours were staged in the T3a subgroup, and their survival data were not significantly different from those of patients with T2b tumours. In addition, T2 subclassification failed to independently predict survival in RCC patients.

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“…When compared with the 2002 TNM classification, novel 2010 TNM classification slightly improved prognostic accuracy (11,13). Ease of use, accumulated knowledge, and wide spread use of TNM primary staging systems maintain its contribution to other predictive models (14,15).…”

Section: Resultsmentioning

confidence: 99%

An Independent Validation of 2010 Tumor-Node-Metastasis Classification for Renal Cell Carcinoma: A Multi-center Study by the Urooncology Association of Turkey Renal Cancer-Study Group

Özkan¹,

Eskiçorapçı²,

Yaycıoğlu³

et al. 2017

jus

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What's known on the subject? and What does the study add?To the best of our knowledge, this is the first study that validates renal cell carcinoma 2010 tumor-node-metastasis for the Turkish population. CSS comparisons between pT1a-pT1b (p=0.022), pT1b-pT2a (p=0.030), pT3a-pT3b (p<0.001) and pT3b-pT4 (p=0.020) were statistically significant. Conversely, pT2a-pT2b (p=0.070) and pT2b-pT3a (p=0.314) were not statistically significant. Multivariable analyses revealed the pT stage in the 2010 TNM classification as an independent prognostic factor for CSS (p for trend=0.002). C-indexes for 2002 and 2010 TNM classifications were 0.8683 and 0.8706, respectively. Conclusion: Subdividing pT2 does not have a CSS advantage. Moving adrenal involvement to pT4 yielded a more accurate prognosis prediction. T stage and LNI are independent prognostic factors for CSS in RCC. Overall, the novel 2010 TNM classification is slightly improved over the former one. However, shown by C-index values, this improvement is not sufficient to state that 2010 TNM outperforms the 2002 TNM.

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Independent Validation of the 2010 American Joint Committee on Cancer TNM Classification for Renal Cell Carcinoma: Results From a Large, Single Institution Cohort

Cited by 127 publications

References 22 publications

EAU Guidelines on Renal Cell Carcinoma: The 2010 Update

EAU Guidelines on Renal Cell Carcinoma: The 2010 Update

Application of the revised Tumour Node Metastasis (TNM) staging system of clear cell renal cell carcinoma in eastern China: advantages and limitations

An Independent Validation of 2010 Tumor-Node-Metastasis Classification for Renal Cell Carcinoma: A Multi-center Study by the Urooncology Association of Turkey Renal Cancer-Study Group

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