Reevaluation of Renal Cell Carcinoma and Perirenal Fat Invasion Only
- 30 November 2009
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Urology
- Vol. 182 (5), 2137-2143
- https://doi.org/10.1016/j.juro.2009.07.065
Abstract
Purpose: Controversy continues over whether perirenal fat invasion in pT3a renal cell carcinoma is a prognostic factor. We investigated the prognosis of renal cell carcinoma with perirenal fat invasion compared to the prognosis of other pathological stages by tumor size. Materials and Methods: We reviewed the medical records of 946 patients who underwent curative surgery for pT1–pT3bN0M0 renal cell carcinoma between 1988 and 2006. Patients with pT3a stage disease and perirenal fat invasion only were divided into 2 subgroups by a 7 cm tumor size cutoff. The prognostic impact of perirenal fat invasion on disease-free and cancer specific survival was investigated. Results: Patients with perirenal fat invasion and lesions greater than 7 cm had lower 5-year disease-free (49.5% vs 77.2%, p = 0.004) and cancer specific (58.5% vs 95.6%, p = 0.003) survival than those with lesions 7 cm or less. Patients with perirenal fat invasion and lesions 7 cm or less had similar 5-year disease-free and cancer specific survival compared to those with pT1 tumors (p = 0.109 and 0.602, respectively). For tumors 7 cm or less multivariate analysis showed that perirenal fat invasion was not a significant predictor of disease-free (p = 0.119) or cancer specific (p = 0.208) survival. In contrast, perirenal fat invasion was an independent prognostic factor for disease-free (p = 0.002) and cancer specific (p = 0.027) survival in patients with tumors greater than 7 cm. Conclusions: Findings suggest that the prognostic significance of perirenal fat invasion depends on primary tumor size. Perirenal fat invasion included in the pT3a stage regardless of tumor size should be reevaluated by tumor size for a more accurate patient prognosis.Keywords
This publication has 20 references indexed in Scilit:
- Prognostic Significance of Perinephric Fat Infiltration and Tumor Size in Renal Cell CarcinomaJournal of Urology, 2008
- Prognostic Relevance of Tumour Size in T3a Renal Cell Carcinoma: A Multicentre ExperienceEuropean Urology, 2007
- Does Stage T3a Renal Cell Carcinoma Embrace a Homogeneous Group of Patients?Journal of Urology, 2007
- Proposal for Reclassification of the TNM Staging System in Patients with Locally Advanced (pT3–4) Renal Cell Carcinoma According to the Cancer-Related OutcomeEuropean Urology, 2007
- Reevaluation of TNM staging of renal cortical tumors: Recurrence and survival for T1N0M0 and T3aN0M0 tumors are equivalentUrology, 2006
- 2004 WHO Classification of the Renal Tumors of the AdultsEuropean Urology, 2006
- SHOULD DIRECT IPSILATERAL ADRENAL INVASION FROM RENAL CELL CARCINOMA BE CLASSIFIED AS pT3a?Journal of Urology, 2005
- CURRENT TNM CLASSIFICATION OF RENAL CELL CARCINOMA EVALUATED: REVISING STAGE T3aJournal of Urology, 2005
- TNM T3a Renal Cell Carcinoma: Adrenal Gland Involvement is Not the Same as Renal Fat InvasionJournal of Urology, 2003
- Prognostic significance of morphologic parameters in renal cell carcinomaThe American Journal of Surgical Pathology, 1982