Primary Tumor Size in Renal Cell Cancer in Relation to the Occurrence of Synchronous Metastatic Disease

Zastrow, Stefan; Anh, Phuong; Bar, I. Von; Novotný, Vladimír; Hakenberg, Oliver W.; Wirth, Manfred P.

doi:10.1159/000356325

Cited by 23 publications

(18 citation statements)

References 23 publications

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“…Zastrow et al [25] reported tumor size and ASA score as significant prognostic factor of metastasis after surgery, although their results did not reach significance in subgroup analysis of SRMs ≤ 4 cm. Takayama et al [26] also reported that symptom at diagnosis, CRP ≥ 0.4 mg/dl, tumor size ≥3.0 cm, histological grade 3, a sarcomatoid component, and microvascular invasion were independent risk factors for metastasis.…”

Section: Discussionmentioning

confidence: 90%

Risk of metastasis for T1a renal cell carcinoma

Lee

Kim

et al. 2015

World J Urol

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Section: Discussionmentioning

confidence: 90%

Risk of metastasis for T1a renal cell carcinoma

Lee

Kim

et al. 2015

World J Urol

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“…The relevance of the tumor size to RCC local advance or distant metastasis has been suggested by some literatures previously. A cohort study showed big tumor is inclined to metastasis [ 32 ]. In agree with this, the study of tumor size and metastasis in RCC patients from 1971–2005 in Iceland found that metastasis risk increased with increasing tumor size, but no linear relationship was found [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Clinicopathologica Epidemiological Characteristics and Change Tendencies of Renal Cell Carcinoma in Shanxi Province of China from 2005 to 2014

Bai

Wang

et al. 2015

PLoS ONE

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ObjectivesRCC is the most common solid renal malignancy in adults worldwide. To provide the insight of clinicopathologica epidemiological characteristics and change tendencies of renal cell carcinoma (RCC), 2154 cases were collected from Shanxi Province of China, including diagnose time, age, gender, tumor size, Fuhrman grade, tumor stage, tumor location, local advance or distant metastasis and first symptom from 2005 to 2014. This retrospectively investigation, as its general objective, was to analyze the clinicopathologica epidemiological characteristics and the change tendencies of RCC.MethodsBetween 2005 and 2014, 2154 patients who were diagnosed with RCC in three large tertiary hospitals at Shanxi Province were included. The patients’ demographic features, pathological diagnoses and metastatic statuses were analyzed. Statistics methods include the chi-squared test, analysis of variance, Spearman’s correlation analysis, Logistic regression and ARIMA modeling.ResultsOf the 2154 included patients, the constituent ratio of female /male was 63.1% and 36.9%, with the median age of 57 years old. Fuhrman grade distributions differed significantly between males and females (p = 0.024). Also, a significant difference in tumor size was found by different clinical stages (p < 0.001), with a linear correlation (p < 0.001). Moreover, Spearman’s analysis indicated tumor grade has a negative correlation with female (p = 0.009) and a positive correlation with tumor size (p = 0.000). It was found that the tumor diameter is bigger in the left side (p = 0.022). Furthermore, the metastasis rate was higher in the bigger tumor (p < 0.001) and the left-sided tumors (p = 0.027). Logistic regression also showed that tumor size is a risk factor for metastasis (OR = 1.724). The risk of local advance or distant metastasis in the left kidney was 1.6-fold greater than that of the right kidney. From 2005 to 2014 the number of RCC cases gradually increased (mainly for pathological grade II and III, but grade I and IV), while the average tumor size decreased, showing the severity increase mildly. Base on the results of a time series analysis-prediction the average RCC size would continue to decrease from the first quarter of 2015 to the fourth quarter of 2016.ConclusionsThe cases of RCC increased from 2005 to 2014 with clear cell type as the main pathological type in this population. The characteristics in the constituent ratios of the RCC vary depending on gender, pathological grade, tumor size, and location, which may be the important factors impacting treatment and prognosis.

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“…The mean age was 67.6 (35-87 years) with a mean BMI of 26.8 kg/m 2 (19.1-36.2 kg/m 2 ). The majority of the patients were male (31 men vs. 9 women) with a mean ASA score of 2.3 [2,3]. Six patients were operated on a single kidney situation, which were the only imperative cases in this study.…”

Section: Resultsmentioning

confidence: 99%

“…Tumors are more frequent diagnosed at a lower stage and before symptoms such as pain or hematuria or synchronous metastases might imply a pathological process [1,2]. Consequently, nephron-sparing surgery in the sense of partial nephrectomy has gained importance in the treatment of renal masses.…”

Section: Introductionmentioning

confidence: 99%

ZIRK-Technique: Zero Ischemia Resection in the Kidney for High-Risk Renal Masses: Perioperative Outcome

Kriegmair¹,

Pfalzgraf²,

Häcker³

et al. 2015

Urol Int

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Objectives: This study evaluates the feasibility and safety of open-partial nephrectomies in the ZIRK-technique (Zero Ischemia Resection in the Kidney) for renal masses with high-risk anatomical features - objectified by the PADUA score. Methods: We identified 40 consecutive cases of partial nephrectomies performed without clamping of the renal artery in our department of urology. Retrospective analysis of the preoperative CT or MRI scans showed 27 cases with a PADUA score ≥8, of which 15 cases had a score ≥10. Cases were in particular assessed regarding operation time (ORT), estimated blood loss (EBL), surgical margins and postoperative complications using the Clavien classification. Results: The mean age of the study population was 67.6 years with an average BMI of 26.8 kg/m². The mean ORT was 1:46 with an average EBL of 521 ml. Clavien grade II complications were observed seven times, while 3 patients had a grade IIIa complication. Despite complex and adverse location of the tumors, nephron-sparing surgery without ischemia could be performed with negative surgical margins for all cases. EBL, transfusion rate and complication were considerably more frequent in high-risk tumors. Conclusion: Highly complex renal tumors, PADUA ≥10, can be resected in ZIRK-technique with good operative outcome and a low complication rate.

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Primary Tumor Size in Renal Cell Cancer in Relation to the Occurrence of Synchronous Metastatic Disease

Cited by 23 publications

References 23 publications

Risk of metastasis for T1a renal cell carcinoma

Risk of metastasis for T1a renal cell carcinoma

Clinicopathologica Epidemiological Characteristics and Change Tendencies of Renal Cell Carcinoma in Shanxi Province of China from 2005 to 2014

ZIRK-Technique: Zero Ischemia Resection in the Kidney for High-Risk Renal Masses: Perioperative Outcome

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