Value of Tumor Size in Predicting Survival from Renal Cell Carcinoma Among Tumors, Nodes and Metastases Stage 1 and Stage 2 Patients

Targonski, Paul V.; Frank, Walter L.; Stuhldreher, David; Guinan, Patrick

doi:10.1016/s0022-5347(17)32427-8

Cited by 70 publications

(26 citation statements)

References 23 publications

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“…Among the classical triad of RCC, i.e., fever, hematuria, and pain, the latter two were important prognostic factors. Age [34], gender [31,35], weight loss [1,34], performance status [1,2], and tumor location and size [7,36] were reported to be ominous prognostic factors in the previous literature using univariate analysis. However, the current multivariate analysis revealed all these factors not to be independent factors significant for survival.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors of renal cell carcinoma: A multivariate analysis

et al. 1998

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Background and Objectives: To establish appropriate therapeutic modalities for renal cell carcinoma (RCC), informations on the factors affecting prognosis of patients are essential. For this purpose, multivariate analysis including a large set of variables is necessary. Methods Prognostic significance of 14 clinical factors and 19 histologic factors including counting of silver‐stained nucleolar organizer regions (AgNORs) were evaluated in 96 patients. Age of patients ranged from 41 to 85 (median 59) yr with a male to female ratio of 4:1. The tumors were staged based on the TNM classification as follows: 7 in stage I, 58 in stage II, 15 in stage III, and 11 in stage IV. Results The overall and metastasis‐free survival rates in all patients were 80.1% and 72.7%, respectively. Multivariate analysis using Cox's proportional hazards model performed on the factors proved to be significant at the univariate analysis. Univariate analysis revealed four clinical factors including presence of macroscopic hematuria, symptoms such as pain and palpable abdominal mass, anemia, and adjuvant therapy, and nine histologic factors, including AgNOR count, to be significant for survival. Multivariate analysis showed that anemia, pathological stage, and AgNOR count were independent factors for overall survival of patients. The AgNOR count, in particular, is the only predictive factor for metastasis‐free survival. Conclusions Among various clinicopathological factors, anemia, pathological stage, and AgNOR count are significant prognosticators of RCC. The AgNOR count is also predictive factor for metastasis‐free survival. J. Surg. Oncol. 1998;68:11–18. © 1998 Wiley‐Liss, Inc.

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Section: Discussionmentioning

confidence: 99%

Prognostic factors of renal cell carcinoma: A multivariate analysis

et al. 1998

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“…In 1993, Gelb et al 20 suggested stratifying organ-confined RCC according to a 5-cm breakpoint. The same data were reconfirmed by Targonski et al, 21 who evaluated 93 patients for whom radical nephrectomy was performed for localized RCC Similarly, data from the Mayo Clinic Kidney Cancer Registry confirmed the use of the 5-cm breakpoint. 22,23 Moreover, this tumor size breakpoint was included in the SSIGN (stage, size, grade, and secrosis) score by Frank et al 24 Other recent articles have proposed the same data.…”

Section: Discussionmentioning

confidence: 55%

Proposal for revision of the TNM classification system for renal cell carcinoma

Ficarra

Guilhot

Schips

et al. 2005

Cancer

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“…At a mean follow-up of 52 months (range 1-203), the overall survival rate was 84% (80 patients), while there was a cancer- 4.5 Kinouchi, 1998 [7] 5.5 Novick, 1997 [5] 4.0 Targonsky, 1994 [9] 5.0 Gelb, 1993 [8] 5.0 specific mortality of 6.3% (6 patients): 5 patients were affected by clear cell carcinoma and 1 had a papillary adenocarcinoma.…”

Section: Resultsmentioning

confidence: 99%

Stage pT1 Renal Cell Carcinoma: Review of the Prognostic Significance of Size

Zucchi

Mearini²,

Mearini³

et al. 2003

Urol Int

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Introduction: The last TNM classification (before 1997) defined T1 kidney tumour as a tumour <2.5 cm, limited to the kidney: this cut-off point was changed in 1997 and T1 neoplasm was defined as <7 cm. This new cut-off now includes past T1 and T2 diseases, without any differences in terms of prognoses. We performed a retrospective analysis of our cases and specifically investigated if there were any differences in terms of prognosis in a group of patients, currently identifiable as pT1, if they were divided into two subgroups based on tumour pathological sizes. Materials and Methods: Our analysis involved 128 patients (mean age 57.6 years) who underwent radical nephrectomy or nephron-sparing surgery in the period between 1990 and 2000. All these patients were pT1 according to the new TNM classification and were divided into two groups according to different cut-off point sizes (from 2.5 to 5 cm). We analysed the surgical approach, overall survival and cancer-specific mortality in the two subgroups, renamed as pT1a and pT1b, and performed a statistical analysis of the results using the Kaplan-Meier method to prove if this substaging identified changes in survival outcome. Results: We obtained more interesting results for a 5-cm cut-off: the two groups showed a similar follow-up and overall survival rate but different cancer-specific mortality rate (6 vs. 12.1%). The statistical analysis showed that the two survival curves (pT1a vs. pT1b disease) had a similar trend up to about 60 months; after this period the two curves diversify with a drop in survival rate among patients with larger tumours (pT1b patients). Conclusions: It would seem reasonable to reassess the TNM classification of stage pT1 in order to better define prognosis in this group of patients.

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Value of Tumor Size in Predicting Survival from Renal Cell Carcinoma Among Tumors, Nodes and Metastases Stage 1 and Stage 2 Patients

Cited by 70 publications

References 23 publications

Prognostic factors of renal cell carcinoma: A multivariate analysis

Prognostic factors of renal cell carcinoma: A multivariate analysis

Proposal for revision of the TNM classification system for renal cell carcinoma

Stage pT1 Renal Cell Carcinoma: Review of the Prognostic Significance of Size

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