Lymphovascular embolization and absent koilocytosis were independent prognostic factors for the risk of lymphatic metastasis. Patients with koilocytosis and without lymphovascular embolization had better 5-year survival.

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Purpose:We evaluated the role of several prognostic factors in predicting death and/or progressive disease in patients with renal cell carcinoma. Materials and Methods: Between 2004 and 2010, 227 consecutive patients with renal cell carcinoma underwent radical nephrectomy at our Institute. All histological specimens were examined by the same pathologist. We considered certain histological parameters, including histological subtype, conventional Fuhrman grade, presence of sarcomatoid features, adrenal gland infi ltration, invasion of the perinephric fat, vascular embolization, collecting system invasion, presence or absence of tumour necrosis (0%, 1% to 49%, or 50% or greater) and regional lymph node metastasis. Results: Variables signifi cantly associated with death and/or progressive disease on univariate analysis were histological subtype (p = 0.006), Fuhrman grade (p < 0.0001), tumor necrosis (p = 0.009), perinephric fat invasion (p = 0.002), vascular embolization (p = 0.0002), presence of lymph node involvement (p < 0.002), tumor size (p = 0.0006), TNM stage (p < 0.00001) and presence of metastasis (p < 0.00001). In the multivariable model histological subtype, tumor necrosis, lymph node involvement and presence of metastasis were independent risk factors for disease-free survival (p = 0.011, 0.042, 0.025 and p < 0.0001, respectively). Conclusion: Histological subtype, tumor necrosis, lymph node involvement and presence of metastasis proved to be independent prognostic factors for disease-free survival. Therefore, the presence and rate of tumor necrosis should always be informed by the pathologist and lymphadenectomy should be performed in all patients. Prognostic factors in renal cell

Sebaceous carcinoma is a very aggressive malignant tumor, derived from the adnexal epithelium of sebaceous glands. Extraocular sebaceous carcinoma is a very uncommon neoplasm usually localized on the head and neck. To our knowledge, there are only 2 previously reported cases of sebaceous carcinoma on the penis. We report the clinicopathologic data on 3 additional cases of sebaceous carcinoma arising in the penis. Treatment is debatable in view of the fact that this kind of tumor has a high recurrence rate and early regional lymph node involvement. Considering these facts, we used preoperative lymphoscintigraphy, intraoperative lymph node mapping and sentinel node biopsy before performing a bilateral inguinal lymphadenectomy in 1 of 3 patients treated in our institute.