Effect of incidental detection for survival of patients with renal cell carcinoma: Results of population-based study of 701 patients

Guðbjartsson, Tómas; Thoroddsen, Ásgeir; Pétursdóttir, Vigdís; Hardarson, Sverrir; Magnússon, Jónas; Einarsson, Guðmundur

doi:10.1016/j.urology.2005.07.009

Cited by 95 publications

(63 citation statements)

References 23 publications

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“…[18][19][20] In our study, the cancer-specific survival rate was significantly higher for tumors detected incidentally, compared to those detected symptomatically; this result suggests that the early detection of PRCC is important for good prognosis.…”

Section: Discussionsupporting

confidence: 45%

Morphological subtyping of papillary renal cell carcinoma: Clinicopathological characteristics and prognosis

et al. 2007

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Aim:The aim of the study was to evaluate the clinicopathological and prognostic significance of morphological subtyping of papillary renal cell carcinoma (PRCC). Methods: The patients treated for renal cell carcinoma in our department from January 1985 to March 2006 were evaluated retrospectively. Thirty-two of the 591 patients (5.4%) were diagnosed with PRCC. To determine the prognostic factors, we re-evaluated the pathological stage according to the 2002 TNM classification of malignant tumors, and the tumor type of renal cell carcinoma according to the 2004 World Health Organization histological classification. Survival was analysed using the Kaplan-Meier method and the log-rank test. Results: The age at diagnosis ranged from 33 to 81 years (median: 63 years old) and the follow-up time after the surgical treatment ranged from 4 to 191 months (median: 54 months). The cancer-specific 5-year survival rate of the 32 PRCC patients was 74%. Pathologically, 17 patients (53%) and 15 patients (47%) were diagnosed with type 1 and type 2 PRCC, respectively. The type 2 PRCC patients had a significantly higher tumor grade (P < 0.001), a more advanced stage (P < 0.001), more frequent vascular invasion (P < 0.001), and a higher sarcomatoid component (P = 0.038) compared to the type 1 PRCC patients. The type 1 patients had a better cancer-specific 5-year survival rate than the type 2 patients (94% vs 50%) (P = 0.008). Conclusion:The morphological subtyping of PRCC is significantly associated with clinicopathological features and the prognosis. Our results provide evidence of the clinical utility of dividing PRCC into two subtypes.

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Section: Discussionsupporting

confidence: 45%

Morphological subtyping of papillary renal cell carcinoma: Clinicopathological characteristics and prognosis

et al. 2007

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“…Her iki grupta, takip süresi içinde ölen toplam hasta sayısı, rastlantısal vakalarda 21 (%32. [14][15][16][17][18][19] Genel olarak BHK'li vakalarda, tümör çapı ve evresi arttıkça tümör rekürrensinin de arttığı ve sağkalım süresinin azaldığı bilinmektedir. Salama ve ark.…”

Section: Bulgularunclassified

“…[14] rastlantısal BHK vakalarını erken evrede yakalamanın tek başına anlamlı olmadığını, en önemli prognostik parametrenin tümörün evresi ve nükleer derecesi olduğunu savunmuştur. Ancak buna rağmen tümör büyüklüğü için 2.3 cm'nin kritik eşik olduğunu bildirmektedir.…”

Section: Bulgularunclassified

Pathological features of incidental and symptomatic renal cell carcinoma

Bayraktar¹,

Atun²

2011

Turkish Journal of Urology

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Objective: Incidental renal cell carcinoma (RCC) cases is increasing significantly. This study compared the pathologic features of incidental and symptomatic RCC cases. Materials and methods:The study divided 114 patients undergoing nephrectomy into two groups: incidental (64 cases) and symptomatic (50 cases) RCC. Patient age, gender, tumor size, histological sub-type, TNM stage, Fuhrman grade, and survival time were determined. Results:The male/female (78/36) ratio was 2.1 and no difference was observed between groups (p= 0.8793). For incidental and symptomatic cases, the mean patient age was 55.5±6.4 vs. 58.8±4.7 years (p= 0.0028), respectively; tumor diameter was 4.8±1.8 vs. 6.7±1.5 cm (p<0.0001); the mean follow-up was 73.8±17.3 vs. 71.3±14.7 months (p= 0.4157); and the mean survival time was 64.7±22.5 vs. 53.5±18.7 months (p= 0.0054). There were 48 (75%), 14 (21.8%), 2 (3.1%), and 0 (0%) pT1, pT2, pT3, and pT4 tumors, respectively, for incidental cases, and 16 (32%), 18 (36%), 14 (28%), and 2 (4%) for symptomatic cases (p= 0.0024, p= 0.0572, p= 0004, and p= 0.1096 for pT1, pT2, pT3, and pT4, respectively). There were 20 (40%) lymphatic metastases in symptomatic cases and 4 (6.2%) in incidental cases (p= 0.0121 and p= 0.0014 for N1 and N2). No patient had distant organ metastases. There were no significant differences between groups in terms of histopathological subtype or Fuhrman grade. Conclusion:Incidental RCC is diagnosed in the early phase, and has better prognostic factors than symptomatic cases in terms of tumor size and stage.Key words: Incidental; pathology; renal cell carcinoma ÖZET Amaç: Rastlantısal böbrek hücreli karsinom (BHK) vakalarında önemli artış gözlenmektedir. Bu çalışma ile rastlantısal BHK vakalarının patolojik özellikleri semptomatik BHK vakaları ile karşılaştırılmıştır. Gereç ve yöntem:Nefrektomi yapılan 114 BHK'li hasta, rastlantısal (64 vaka) ve semptomatik (50 vaka) BHK şeklinde iki gruba ayrılarak incelendi. Tüm hastaların yaşı, cinsiyeti, tümör büyüklüğü, histolojik alt tipi, evresi (TNM), derecesi (Fuhrman grade) ve sağkalım süreleri tespit edildi.Bulgular: Erkek/kadın hasta oranı 2.1 idi (78/36) ve gruplar arasında farklılık yoktu (p= 0.8793). Hastaların ortalama yaşı, rastlantısal vakalarda 55.5±6.4 yıl, semptomatik vakalarda 58.8±4.7 yıl idi (p= 0.0028). Tü-mör çapı, rastlantısal vakalarda 4.8±1.8 cm, semptomatik vakalarda 6.7±1.5 cm idi (p<0.0001). Rastlantısal ve semptomatik vakalarda, ortalama takip süresi, sırası ile 73.8±17.3 ay ve 71.3±14.7 ay (p= 0.4157), ortalama sağkalım süresi, sırası ile 64.7±22.5 ay ve 53.5±18.7 ay (p= 0.0054) idi. pT1, pT2, pT3 ve pT4 tümörler, rastlantısal vakalarda sırası ile 48 (%75), 14 (%21.8), 2 (%3.1) ve 0 (%0), semptomatik vakalarda ise 16 (%32), 18 (%36), 14 (%28) ve 2 (%4) idi (pT1, pT2, pT3 ve pT4 için sırası ile p= 0.0024, p= 0.0572, p= 0004 ve p= 0.1096). Lenfatik metastaz sayısı, semptomatik vakalarda 20 (%40), rastlantısal vakalarda ise 4 (%6.2) idi (N1 ve N2 için p= 0.0121 ve p= 0.0014). Hiçbir hastada uzak organ metastaz...

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“…24 The improved cancer-specific survival of incidental cases has not, thus far, resulted in a decrease in overall mortality from kidney cancer, perhaps because of this lead-time bias. 25 The most important limitation of our retrospective single centre study was that we only reported patients who underwent nephrectomy. As a result, we were not able to report incidence or prevalence of RCC given that this was an analysis of a purely surgical series.…”

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confidence: 99%

Clinico-pathological analysis of renal cell carcinoma demonstrates decreasing tumour grade over a 17-year period

Nason

McGuire

Kelly

et al. 2014

CUAJ

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Introduction: Renal cell carcinoma (RCC) represents about 3% of adult malignancies in Ireland. Worldwide there is a reported increasing incidence and recent studies report a stage migration towards smaller tumours. We assess the clinico-pathological features and survival of patients with RCC in a surgically treated cohort. Methods: A retrospective analysis of all nephrectomies carried out between 1995 and 2012 was carried out in an Irish tertiary referral university hospital. Data recorded included patient demographics, size of tumour, tumour-node-metastasis (TNM) classification, operative details and final pathology. The data were divided into 3 equal consecutive time periods for comparison purposes: Group 1 (1995)(1996)(1997)(1998)(1999)(2000), Group 2 (2001Group 2 ( -2006 and Group 3 (2007Group 3 ( -2012. Survival data were verified with the National Cancer Registry of Ireland. Results: In total, 507 patients underwent nephrectomies in the study period. The median tumour size was 5.8 cm (range: 1.2-20 cm) and there was no statistical reduction in size observed over time (p = 0.477). A total of 142 (28%) RCCs were classified as pT1a, 111 (21.9%) were pT1b, 67 (13.2%) were pT2, 103 (20.3%) were pT3a, 75 (14.8%) were pT3b and 9 (1.8%) were pT4. There was no statistical T-stage migration observed (p = 0.213). There was a significant grade reduction over time (p = 0.017). There was significant differences noted in overall survival between the T-stages (p < 0.001), nuclear grades (p < 0.001) and histological subtypes (p = 0.022). Conclusion: There was a rising incidence in the number of nephrectomies over the study period. Despite previous reports, a stage migration was not evident; however, a grade reduction was apparent in this Irish surgical series. We can demonstrate that tumour stage, nuclear grade and histological subtype are significant prognosticators of relative survival in RCC.

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Effect of incidental detection for survival of patients with renal cell carcinoma: Results of population-based study of 701 patients

Cited by 95 publications

References 23 publications

Morphological subtyping of papillary renal cell carcinoma: Clinicopathological characteristics and prognosis

Morphological subtyping of papillary renal cell carcinoma: Clinicopathological characteristics and prognosis

Pathological features of incidental and symptomatic renal cell carcinoma

Clinico-pathological analysis of renal cell carcinoma demonstrates decreasing tumour grade over a 17-year period

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