Multiinstitutional European validation of the 2002 TNM staging system in conventional and papillary localized renal cell carcinoma

Abstract

BACKGROUNDThe current study validated the 2002 edition of the TNM staging system in a multicenter, multinational European series of localized renal cell carcinoma (RCC).METHODSThe authors analyzed the clinical data of 2217 patients who had undergone radical or partial nephrectomy for localized RCC in 7 urologic centers.RESULTSIn the current study, 1065 patients (48%) were classified as having pT1a disease, 771 (34.8%) were classified as having pT1b disease, and 381 (17.2%) were classified as having pT2 disease. Tumor histotype was conventional RCC in 1886 patients (85%), papillary in 182 (8.2%) patients, chromophobe in 64 (2.9%) patients, and unclassified in 85 (3.8%) patients. The mean follow‐up time was 65.36 ± 52.09 months. The 5 and 10‐year disease‐specific survival probabilities were 95.3% and 91.4% in patients with pT1a disease, 91.4% and 83.4% in patients with pT1b disease, and 81.6% and 75.2% in patients with pT2 disease (log‐rank test P value = 0.0000). The disease‐specific survival rates of patients with pT1a RCC were significantly higher than those recorded in patients with pT1b and pT2 RCC. Similarly, the disease‐specific survival probabilities of patients with pT1b RCCwere significantly better than those of patients with pT2 RCC. Analyzing the seven series individually, the 2002 TNM staging system provided appropriate stratification for only one series. The 2002 TNM staging system allowed significant stratification of the cancer‐related outcomes in the subgroup of patients with conventional RCC but not in those with papillary carcinomas.CONCLUSIONSThe application of the 2002 TNM staging system in the current multicenter series enabled the authors to demonstrate optimal stratification of patients with localized RCC. Stratifying by tumor histotype, the data coming from the whole group analysis were reconfirmed for clear cell RCC only. Cancer 2005. © 2005 American Cancer Society.

VHL and HIF-1α: gene variations and prognosis in early-stage clear cell renal cell carcinoma

“…The ccRCC subtype accounts for 80 % of sporadic RCCs and can often be cured, if diagnosed on time, and treated when still localized to the kidney (intracapsular) [1]. Overall, intracapsular ccRCCs are known to have a good prognosis.…”

“…Renal cell carcinoma (RCC) is the most common malignant tumor in the adult kidney, accounting for about 3 % of all human malignancies with the clear cell subtype (ccRCCs) represented 80 % of all RCCs [1].…”

“…Von Hipple-Lindau gene is a tumor suppressor gene (TSG) mapping at 3p25-26 and containing three exons [1]. Under normal conditions, the protein encoded by VHL, pVHL, localizes preferentially in the cytoplasm maintaining, however, the ability to shuttle between cytoplasm and nucleus [4].…”

Overexpression of IL-32 is a novel prognostic factor in patients with localized clear cell renal cell carcinoma

“…Nodal invasion was confirmed to be a significant independent prognostic factor (28). However, the sub-classification of nodal invasion by the number of involved nodes is controversial (31). Secondly, histological prognostic factors include Fuhrman nuclear grade; RCC subtype; tumor necrosis; vascular invasion; and the presence of sarcomatoid features.…”

Urinary Collecting System Invasion is an Independent Prognostic Factor of Organ Confined Renal Cell Carcinoma

“…TNM staging system remains the most useful determinant in disease classification reflecting the propensity of these tumors to extend locally (T), involve regional lymph nodes (N) and initiate metastatic growth (M) 3 .…”