Clinicopathological factors predicting recurrence of N0M0 renal cell carcinoma: A case series analysis of one facility

Abstract

Background : Although many factors have been reported as predictors of the recurrence of renal cell carcinoma (RCC), none of the factors are consistent among different studies. In the study presented here, the potential clinicopathological predictors of the recurrence of N0M0 RCC were examined. Methods : A total of 201 patients who underwent nephrectomy for N0M0 RCC were examined to determine the pathological tumor stage (pT stage), pathological tumor grade of malignancy (tumor grade), symptoms, and tumor size.Results : RCC recurred in 29 patients (14.4%), 50% of whom developed new tumors within 24 months after nephrectomy. The disease-free 3-and 10-year survival rates declined as the pT stage and tumor grade increased: these rates were, respectively, 98.6% and 86.5% for pT1a; 93.7% and 87.9% for pT1b; 100% and 100% for pT2; 78.6% and 58.0% for pT3a; and 88.9% and 16.7% for pT3b. Significant differences in the recurrence rate were noted between pT3 and pT1 or pT2, as well as between grade 3 disease and grade 1 or grade 2 tumors. Multivariate analysis showed that a combination of the pT stage, grade, and presence of symptoms was useful for predicting the recurrence of RCC. Conclusion : The present study showed that patients undergoing nephrectomy for N0M0 RCC should be followed-up carefully for 2 years postoperatively with special attention to high pT stage, high grade, and the development of symptoms.

Kattan postoperative nomogram for renal cell carcinoma: Predictive accuracy in a Japanese population

“…Earlier studies have also suggested that nuclear grade is an important prognostic factor. An examination of the correlation between tumor grade and recurrence rate showed that recurrence was significantly high in patients with grade 3 disease, 18 and the recurrence rate was also found to be significantly higher in pT1 and pT3 patients with grade 3 disease 19 . An examination of the association of recurrence rate with symptoms at the first presentation showed a significantly higher recurrence rate in patients with symptoms, as was found in a previous study 20 .…”

“…An examination of the correlation between tumor grade and recurrence rate showed that recurrence was significantly high in patients with grade 3 disease, 18 and the recurrence rate was also found to be significantly higher in pT1 and pT3 patients with grade 3 disease. 19 An examination of the association of Kattan nomogram for RCC recurrence rate with symptoms at the first presentation showed a significantly higher recurrence rate in patients with symptoms, as was found in a previous study. 20 Other data have indicated that microvascular invasion is a significant prognostic value in RCC patients because systemic progression depends on tumor access to the microvasculature, although it was not proven to be a significant prognostic factor in this study.…”

Clinicopathological features of recurrence after radical surgery for nonmetastatic renal cell carcinoma

“…These findings are consistent with previously reported results. [4][5][6][7][9][10][11] Moreover, these factors, except for sex, were found to be significant predictors of disease recurrence by univariate analysis; however, multivariate analysis showed that only the pathological stage was an independent predictor of recurrence. In fact, the recurrence rate after surgery increased in accordance with the increase in pathological stage in this series; that is, tumor recurrence was shown in 8.0%, 22.2%, and 52.5% of patients with pT1, pT2, and pT3 disease, respectively.…”