Influence of Tumor Stage, Size, Grade, Vascular Involvement, Histological Cell Type and Histological Pattern on Multifocality of Renal Cell Carcinoma

Baltacı, Sümer; Orhan, Dıclehan; Soyupek, Sedat; Bedük, Yaşar; Tulunay, Özden; Göğüş, Orhan

doi:10.1016/s0022-5347(05)67443-5

Cited by 68 publications

(17 citation statements)

References 19 publications

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“…[14] Baltaci et al reported that only the pathological stage of the primary tumor was a significant predictor of RCC multifocality in stages T3 versus T1 and T2 cancers. [15] In our study, the incidence of multicentricity in primary tumors <5 cm was not significantly lower than that in tumors larger than this size. Our results also suggest that vascular invasion is an important risk factor for multifocality in patients with RCC.…”

Section: Discussioncontrasting

confidence: 51%

Multicentricity and its associated clinicopathological risk factors in renal cell carcinoma

Özgür¹,

Gönenç²,

Yazicioğlu³

2009

Urol Ann

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Section: Discussioncontrasting

confidence: 51%

Multicentricity and its associated clinicopathological risk factors in renal cell carcinoma

Özgür¹,

Gönenç²,

Yazicioğlu³

2009

Urol Ann

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“…In a review of series published between 1988 to 1999, multifocal disease was noted in 15.2% (179/1,180) of patients, with 9–100% of the primary tumors being ≤ 4 cm in individual reports [13]. Contemporary series have shown a similar rate of multifocal RCC, ranging from 4.3% to 21.4% [4–9, 17, 18]. With the known incidence of multifocal disease, the ability to identify multifocal renal tumors preoperatively is extremely important and has been evaluated by several series.…”

Section: Discussionmentioning

confidence: 99%

“…However, only two series have performed multivariate analysis when evaluating the associations between multifocality and clinicopathologic features. Baltaci et al evaluated 103 cases of RCC and noted the incidence of multifocal RCC to be 21.4% [18]. Univariate and multiple logistic regression analysis demonstrated that primary tumor stage was the only independent predictor of multifocality.…”

Section: Discussionmentioning

confidence: 99%

Multifocal Renal Cell Carcinoma: Clinicopathologic Features and Outcomes for Tumors≤4 cm

Crispen

Lohse

Blute

2008

Advances in Urology

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A significant increase in the incidental detection of small renal tumors has been observed with the routine use of cross-sectional abdominal imaging. However, the proportion of small renal tumors associated with multifocal RCC has yet to be established. Here then, we report our experience with the treatment of multifocal RCC in which the primary tumor was ≤4 cm. In our series of 1113 RCC patients, 5.4% (60/1113) had multifocal disease at the time of nephrectomy. Discordant histology was present in 17% (10/60) of patients with multifocal RCC. Nephron sparing surgery was utilized more frequently in patients with solitary tumors. Overall, cancer-specific, and distant metastasis-free survival appeared to be similar between multifocal and solitary tumors. These findings are consistent with previous series which evaluated multifocal RCC with tumors >4 cm. With the known incidence of multifocality RCC, careful inspection of the entire renal unit should be performed when performing nephron sparing surgery.

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“…It has been shown that the incidence of multifocal disease ranges from 6–25% in the sporadic population 5. Multifocality is considerably higher in the hereditary renal cancer population, such as in patients with von Hippel-Lindau, hereditary papillary renal carcinoma and Birt-Hogg-Dubé.…”

mentioning

confidence: 99%

Initial Experience With Robot Assisted Partial Nephrectomy for Multiple Renal Masses

et al. 2009

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Purpose To evaluate the feasibility of performing robot assisted partial nephrectomy in patients with multiple renal masses and to examine the results of our initial experiences. Materials and Methods We reviewed the records of 10 patients with multiple renal masses who underwent attempted robot assisted partial nephrectomy within the past 2 years. Demographic information as well as intraoperative, perioperative, and renal functional outcome data of these patients were reviewed. Results A total of 24 tumors in 9 patients were removed with robotic assistance. There was 1 open conversion with successful completion of partial nephrectomy. 70% (7 of 10) of patients were affected with a known hereditary renal cancer syndrome, while the remaining patients had multifocal disease with unknown germline genetic alterations. A frozen section from the tumor bed was evaluated in 5 of 10 cases and was negative in each case. 1 patient experienced post operative urinary leak resolving on post operative day 9 without intervention. Twenty-two of the 24 masses resected robotically were malignant. Our most recent 3 patients underwent successful partial nephrectomy without hilar clamping obviating the need for warm ischemia. Overall renal function was unchanged at the most recent follow up with only minimal decrease in differential function of the operated kidney. Conclusions Robot assisted partial nephrectomy for multiple renal masses is feasible in our early experience. Patient selection is paramount for successful minimally invasive surgery. Robot assisted partial nephrectomy without hilar clamping, especially in the hereditary patient population in which repeat ipsilateral partial nephrectomy may be anticipated, appears promising but requires further evaluation.

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Influence of Tumor Stage, Size, Grade, Vascular Involvement, Histological Cell Type and Histological Pattern on Multifocality of Renal Cell Carcinoma

Abstract: Our results imply that primary tumor stage is a significant factor for multifocal disease. Therefore, more precise preoperative staging of the primary lesion is required if nephron sparing surgery is indicated.

Cited by 68 publications

References 19 publications

Multicentricity and its associated clinicopathological risk factors in renal cell carcinoma

Multicentricity and its associated clinicopathological risk factors in renal cell carcinoma

Multifocal Renal Cell Carcinoma: Clinicopathologic Features and Outcomes for Tumors≤4 cm

Initial Experience With Robot Assisted Partial Nephrectomy for Multiple Renal Masses

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