Prognostic significance of Fuhrman grade and age for cancer-specific and overall survival in patients with papillary renal cell carcinoma: results of an international multi-institutional study on 2189 patients

Borgmann, Hendrik; Musquera, Mireía; Haferkamp, Axel; Vilaseca, Antoni; Klatte, Tobias; Shariat, Shahrokh F.; Scavuzzo, Anna; Rı́os, Miguel A.; Wolff, Ingmar; Capitanio, Umberto; Dell’Oglio, Paolo; Krabbe, Laura Maria; Herrmann, Edwin; Ecke, Thorsten; Vergho, Daniel; Huck, Nina; Wagener, Nina; Pahernik, Sascha; Zastrow, Stefan; Wirth, Manfred P.; Surcel, C.; Mirvald, C.; Procházková, Kristýna; Hutterer, Georg C.; Zigeuner, Richard; Cindolo, Luca; Hora, Milan; Stief, Christian G.; May, Matthias; Brookman‐May, Sabine

doi:10.1007/s00345-017-2078-5

Cited by 23 publications

(20 citation statements)

References 27 publications

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“…In accordance with published data, our study confirmed the impact of Fuhrman grade and status of surgical margins on survival [ 21 , 22 ]. Our results also agree with studies by Ficarra et al and Patard et al [ 23 , 24 ].…”

Section: Discussionsupporting

confidence: 92%

Prognostic effect of renal collecting system invasion on survival of patients with renal cell carcinoma and tumor thrombus

Przydacz

Gołąbek

Okoń

et al. 2020

Cent european J Urol

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Introduction Urinary collecting system invasion (UCSI) has been found to have significant prognostic value for patients with renal cell carcinoma (RCC). However, for RCC patients with venous tumor thrombus (VTT), only contradictory data exist regarding the prognostic efficacy of UCSI. Therefore, the aim of this study is to assess the prognostic relevance of UCSI in survival of patients with RCC and VTT. Material and methods Medical records in a prospectively maintained institutional database were analyzed for RCC-VTT patients who had undergone nephrectomy with thrombectomy. Then, the effect of UCSI on overall survival was analyzed. Results The study examined data for 114 patients, including patients with VTT present in the renal vein (35 patients, 31%), infrahepatic inferior vena cava (28 patients, 24%), and suprahepatic inferior vena cava (51 patients, 45%). Nineteen percent of patients had UCSI. The median overall survival of patients with UCSI was 9 months, whereas median overall survival was 10 months for patients without collecting system invasion. Survival and regression analyses rejected UCSI as a prognostic marker for overall survival. Conclusions UCSI has no effect on survival in our cohort of RCC-VTT patients. Therefore, it should not be considered in risk stratification models or in treatment decision-making for this patient group.

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Section: Discussionsupporting

confidence: 92%

Prognostic effect of renal collecting system invasion on survival of patients with renal cell carcinoma and tumor thrombus

Przydacz

Gołąbek

Okoń

et al. 2020

Cent european J Urol

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“…From our perspectives, several points should be noted when we take the prior findings into consideration. Firstly, some studies investigated the prognosis of the subtypes after the data were adjusted against the effects of Fuhrman grade [10,20]. Delahunt et al indicated that Fuhrman grading was inappropriate for PRCC and recommended WHO/ISUP grading system [21].…”

Section: Discussionmentioning

confidence: 99%

Comparison of clinicopathologic parameters and oncologic outcomes between type 1 and type 2 papillary renal cell carcinoma

Wang

Zhao

et al. 2020

BMC Urol

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Background To compare the clinicopathologic parameters and oncologic outcomes between type 1 and type 2 papillary renal cell carcinoma (PRCC). Methods This study was approved by the review board (NO.XYFY2019-KL032–01). Between 2007 and 2018, 52 consecutive patients who underwent surgery at a single tertiary referral hospital were included. Clinicopathologic and survival data were collected and entered into a database. The Kaplan-Meier method, and univariate and multivariate Cox proportional hazard regression analyses were performed to estimate progression-free survival (PFS) and cancer-specific survival (CSS). Results Of the 52 patients, 24 (46.2%) were diagnosed with type 1 PRCC, and 28 (53.8%) had type 2 PRCC. The mean tumor size was 4.8 ± 2.5 cm. The two subtypes displayed different morphological features: foamy macrophages were more common in type 1 PRCC, while eosinophils and microvascular angiolymphatic invasion were more frequent in type 2 PRCC. Type 2 cases showed higher tumor stage and World Health Organization/International Society of Urological Pathology (WHO/ISUP) grade than type 1 cases (T3-T4: 43% vs 17%, P = 0.041; G3-G4: 43% vs 8%, P = 0.005). In univariate analysis, type 2 PRCC had a lower probability for PFS and CSS than patients with type 1 PRCC (P = 0.016, P = 0.049, log-rank test, respectively). In multivariate analysis, only WHO/ISUP grade (HR 11.289, 95% CI 2.303–55.329, P = 0.003) and tumor size (HR 1.244, 95% CI 1.034–1.496, P = 0.021) were significantly associated with PFS. Conclusions PRCC subtype displayed different morphological features: foamy macrophages, eosinophils and microvascular angiolymphatic invasion are pathologic features that may aid in the distinction of the two subtypes. Histologic subtype of PRCC is not an independent prognostic factor and only WHO/ISUP grade and tumor size were independent predictors for PFS.

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“…In the case of an increase in the size of the renal mass during follow-up, the previously postponed treatment (surgery or ablation therapy) was initiated [28,29]. In addition to the size of the mass, its FG was shown to be connected to the prognosis of RCC subtypes [31]. However, currently, no tumor markers have been discovered that could provide insight about the FG of renal masses preoperatively.…”

Section: Discussionmentioning

confidence: 99%

The Role of Hematological Parameters in Predicting Fuhrman Grade and Tumor Stage in Renal Cell Carcinoma Patients Undergoing Nephrectomy

Kısa¹,

Yücel²,

Keskın³

et al. 2019

Medicina

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Background and objective: We investigated the ability of preoperative serum values of red blood cell distribution width (RDW), neutrophil lymphocyte ratio (NLR) and plateletcrit (PCT) to predict Fuhrman grades (FG) and tumor stages of renal cell carcinoma in patients who underwent radical nephrectomy. Materials and methods: Records of 283 patients that underwent radical or partial nephrectomy of renal masses at our clinic between January 2010 and April 2018, whose pathology results indicated renal cell carcinoma (RCC), and who had their FG and T1–4 N0M0 identified were retrospectively evaluated. The patients were divided into two groups based on their FG as low (I–II) and high (III–IV) and their T stages were similarly grouped as limited to kidney (pT1–pT2) and not limited to kidney (pT3–pT4). Results: Mean RDW, NLR, PCT cut-off values of the patients for FG and T stage were 15.65%, 3.54, 0.28% and 14.35%, 2.69, 0.28%, respectively. The RDW and NLR were determined to be statistically significant predictors of a pathologically high FG, whereas the PCT value was not a statistically significant predictor of high FG (p = 0.003, p = 0.006, p = 0.075, respectively). The relationship of RDW, NLR and PCT values with a limited to the kidney pathological T stage revealed statistically significant correlations for all three values. Conclusions: We determined that only RDW and NLR were markers predicting FG, while PCT had no prognostic value. On the other hand, all three of these values were associated with a limited to the kidney pathological T stage in patients who underwent nephrectomy due to renal masses and whose pathologies suggested RCC.

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Prognostic significance of Fuhrman grade and age for cancer-specific and overall survival in patients with papillary renal cell carcinoma: results of an international multi-institutional study on 2189 patients

Abstract: FG is a strong prognostic factor for CSS in papRCC patients. In addition, patients older than 75 have worse CSM than patients younger than 50 years. These findings should be considered for clinical decision making.

Cited by 23 publications

References 27 publications

Prognostic effect of renal collecting system invasion on survival of patients with renal cell carcinoma and tumor thrombus

Prognostic effect of renal collecting system invasion on survival of patients with renal cell carcinoma and tumor thrombus

Comparison of clinicopathologic parameters and oncologic outcomes between type 1 and type 2 papillary renal cell carcinoma

The Role of Hematological Parameters in Predicting Fuhrman Grade and Tumor Stage in Renal Cell Carcinoma Patients Undergoing Nephrectomy

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