Histological Analysis of the Kidney Tumor-Parenchyma Interface

Azhar, Raed A.; Abreu, André Luís de Castro; Broxham, Eric J.; Sherrod, Andy; Ma, Yanling; Cai, Jie; Gill, Tania; Desai, Mihir; Gill, Inderbir S.

doi:10.1016/j.juro.2014.08.010

Cited by 57 publications

(61 citation statements)

References 23 publications

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“…11,12,24 Additionally, higher rates penetrating pseudocapsule disease in RCC may be seen in patients with of higher Fuhrman grade tumors and more advanced TNM stage. 6,[8][9][10]23 In the current study, i-Cap scores of 1, 2 and 3 were assigned to 79 (24%), 176 (54%) and 72 (22%) tumors, respectively amongst the entire cohort. Tumors scored as i-Cap 2 made up largest percentage of the cohort.…”

Section: Discussionmentioning

confidence: 97%

“…The integrity of the pseudocapsule may vary greatly depending on the histological features of the tumor it surrounds. 11,23,24 Previous literature has demonstrated that tumor subtype may be predictive of pseudocapsule characteristics. 11,12,24 Additionally, higher rates penetrating pseudocapsule disease in RCC may be seen in patients with of higher Fuhrman grade tumors and more advanced TNM stage.…”

Section: Discussionmentioning

confidence: 99%

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Standardized Reporting of Microscopic Renal Tumor Margins: Introduction of the Renal Tumor Capsule Invasion Scoring System

et al. 2017

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KEY OF DEFINITIONS FOR ABBREVIATIONS:Renal tumor enucleation allows for maximal parenchymal preservation. Identifying pseudocapsule integrity is critically important in nephron sparing surgery by enucleation. Tumor invasion into and through capsule may have clinical implications although it is not routinely commented on in standard pathologic reporting. We sought to describe a system to standardize the varying degrees of pseudocapsule invasion and to identify predictors of invasion. Materials and Methods:A multicenter retrospective review was carried out between

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Standardized Reporting of Microscopic Renal Tumor Margins: Introduction of the Renal Tumor Capsule Invasion Scoring System

et al. 2017

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“…To better inform the anatomic and oncologic propriety of enucleative PN, histologic examination of the tumor-parenchyma interface was performed on 124 nephrectomy specimens [11]. Some 82% of malignant tumors had an intrarenal pseudocapsule (PC) with a median thickness of 0.6 mm.…”

Section: Evidence Synthesismentioning

confidence: 99%

A Literature Review of Renal Surgical Anatomy and Surgical Strategies for Partial Nephrectomy

et al. 2015

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Context A detailed understanding of renal surgical anatomy is necessary to optimize preoperative planning and operative technique and provide a basis for improved outcomes. Objective To evaluate the literature regarding pertinent surgical anatomy of the kidney and related structures, nephrometry scoring systems, and current surgical strategies for partial nephrectomy (PN). Evidence acquisition A literature review was conducted. Evidence synthesis Surgical renal anatomy fundamentally impacts PN surgery. The renal artery divides into anterior and posterior divisions, from which approximately five segmental terminal arteries originate. The renal veins are not terminal. Variations in the vascular and lymphatic channels are common; thus, concurrent lymphadenectomy is not routinely indicated during PN for cT1 renal masses in the setting of clinically negative lymph nodes. Renal-protocol contrast-enhanced computed tomography or magnetic resonance imaging is used for standard imaging. Anatomy-based nephrometry scoring systems allow standardized academic reporting of tumor characteristics and predict PN outcomes (complications, remnant function, possibly histology). Anatomy-based novel surgical approaches may reduce ischemic time during PN; these include early unclamping, segmental clamping, tumor-specific clamping (zero ischemia), and unclamped PN. Cancer cure after PN relies on complete resection, which can be achieved by thin margins. Post-PN renal function is impacted by kidney quality, remnant quantity, and ischemia type and duration. Conclusions Surgical renal anatomy underpins imaging, nephrometry scoring systems, and vascular control techniques that reduce global renal ischemia and may impact post-PN function. A contemporary ideal PN excises the tumor with a thin negative margin, delicately secures the tumor bed to maximize vascularized remnant parenchyma, and minimizes global ischemia to the renal remnant with minimal complications. Patient summary In this report we review renal surgical anatomy. Renal mass imaging allows detailed delineation of the anatomy and vasculature and permits nephrometry scoring, and thus precise, patient-specific surgical planning. Novel off-clamp techniques have been developed that may lead to improved outcomes.

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“…Также нами отмечено, что опухоль имела плохо выраженную псевдокапсулу, поэтому при выполнении атипичной энуклеорезекции у пациентов было возможно оставление участка опу-холевой ткани в области дна резекции, который мог служить причиной развития местного рецидива опу-холи. По данным мировых исследований, псевдокап-сула имеет ся у 82 % опухолей паренхимы почки, тол-щина данной структуры опухоли в среднем составляет до 0,6 мм [13].…”

Section: Fig 1 the 1 St Patient's Data: а б -3d Modeling Of Patholunclassified

“…Однако, по данным R. A. Azhar и соавт., на основа-нии исследования данных 123 пациентов, подвергну-тых резекции почки, инвазия псевдокапсулы была установлена в 28 % случаев у больных с опухолью по-чки со стадией Т1а, при этом у всех больных морфо-логически был подтвержден отрицательный хирурги-ческий край [13].…”

Section: Fig 1 the 1 St Patient's Data: а б -3d Modeling Of Patholunclassified

Local recurrences after laparoscopic resections for renal parenchymal cancer

Аляев¹,

Rapoport²,

Безруков³

et al. 2017

Androl. genit. hir.

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Histological Analysis of the Kidney Tumor-Parenchyma Interface

Cited by 57 publications

References 23 publications

Standardized Reporting of Microscopic Renal Tumor Margins: Introduction of the Renal Tumor Capsule Invasion Scoring System

Standardized Reporting of Microscopic Renal Tumor Margins: Introduction of the Renal Tumor Capsule Invasion Scoring System

A Literature Review of Renal Surgical Anatomy and Surgical Strategies for Partial Nephrectomy

Local recurrences after laparoscopic resections for renal parenchymal cancer

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