Evaluation of Effect of Lymph Node Involvement on Prognosis of Clear Cell Renal Cell Cancer and Role of Tumor Size and Grade on Prediction of Lymph Node Involvement

Abstract

Amaç:One of the main factors affecting prognosis of renal tumors is lymph node (LN) involvement. Therefore prediction of LN involvement is quite important for prognosis of disease and survival. In this study, we aimed to identify the effect of LN involvement on survival and factors that predict LN positivity. Gereç ve Yöntem: Data of 515 patients undergoing nephrectomy with the prediagnosis of renal cell cancer between January 1996 and February 2014 was investigated retrospectively. All patients were evaluated for lymph node involvement and its effect on survival. Additionally data regarding age, gender, tumor grade and tumor size were collected and their role on prediction of LN involvement was investigated. Bulgular: The number of patients with and without pathologic LN involvement were 39 (7.6%) and 476 (92.4%), respectively. Five years overall survival rate of the patients without LN involvement was 72.3% and it was 32.3% in patients with LN involvement. In 13 (33%) of 39 LN positive patients, tumor size was greater than 10 cm. In 49 (10.2%) of 476 LN negative patients tumor size was greater than 10 cm. When 10 cm is taken as cut off value in terms of tumor size, LN positivity was found to be statistically significant (p=0.006, OR: 2.93, 95% C.I: 1.359-6.320). Fuhrman grade was determined as an independent risk factor to predict LN involvement (p=0.0001, OR: 4.96, 95% C.I: 2.117-11.635). Sonuç: Survival rate of the patients with LN metastasis was found to be worse than patients without LN involvement. Tumor size and Fuhrman grade were found as independent risk factors to predict LN metastasis.