Histological Grading of Renal Cell Carcinoma

Hermanek, P.; Sigel, A.; Chlepas, S

doi:10.1159/000472001

Cited by 58 publications

(28 citation statements)

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“…The pathological-anatomical diagnosis revealed a renal cell carci noma with a diameter of 10 cm. In accordance with the histological and cytological characteristics, a tumor with the histological degree of malignancy III according to Hermanek et al [11] was present. Tumor stage and classification: T2NsMoVo, Robson stage I.…”

Section: Case Reportsupporting

confidence: 58%

“…With conservative treatment, the tumor stage was determined according to clinical and apparative-diagnostic measures. The histo logical degree of malignancy was classified according to Hennanek et al [11].…”

Section: Methodsmentioning

confidence: 99%

“…4. In reference to the histopathologic degree of malignancy of single prognostic parameters, the cumulative survival rates of primarily non-metastasized men and women with a histologic degree of malignancy 1 (n = 34), histologic degree of malignan cy II (n = 105) and a histologic degree of malignancy III (n = 53) according to Hermanek et al [11], All patients (n = 192) under went tumor nephrectomy with curative purposes at the time of diagnosis. Fig.…”

Section: Renal Vein Involvementmentioning

confidence: 99%

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The Value of Morphological Prognostic Criteria in the Assessment of Renal Cell Carcinoma

Jonas¹,

Thoma²,

Beckert³

et al. 1985

Urol Int

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In this study, we examined some of the morphological values from the large number of prognostic parameters indicated in the literature by establishing survival statistics. Primary distant metastasis formation was confirmed to be a prognostically unfavorable factor. Regional metastasis formation takes an intermediate position between the primarily distantly metastasized and the primary non-metastasized renal cell carcinoma. In the primarily non-metastasized renal cell carcinoma, tumor invasion into the renal vein is associated with prognostic deterioration, obviously due to a linkage to other unfavorable tumor characteristics. The histological degree of malignancy as a single prognostic parameter seems to be of little informational value if no other tumor data are taken into consideration. The classification of renal tumors according to Robson proves to be of great clinical relevance, especially when it is combined with the histological degree of malignancy. The prognostic scheme by Hermanek ‘combined staging and grading’ must be recommended as the prognostic scheme of choice. Apart from special histological types of the renal cell carcinoma, such as the papillary or sarcomatous variant, and with reservation as to the tendency to unpredictable secondary metastasis formation that is peculiar to the renal cell carcinoma, a prediction of the prognosis according to the morphological criteria mentioned above is possible to a satisfactory degree within certain limits.

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Section: Case Reportsupporting

confidence: 58%

Section: Methodsmentioning

confidence: 99%

Section: Renal Vein Involvementmentioning

confidence: 99%

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The Value of Morphological Prognostic Criteria in the Assessment of Renal Cell Carcinoma

Jonas¹,

Thoma²,

Beckert³

et al. 1985

Urol Int

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“…Since the publication of Griffith and Thackray's study eight additional composite grading systems for RCC have been proposed, with classification criteria including tumor architecture, cellular differentiation, nuclear features, and the presence or absence of tumor necrosis [9][10][11][12][13][14][15][16] (Table 1). In addition to these, several other grading systems have been formulated, however, rather than concentrating of cellular differentiation they include a variety of morphologic parameters that, in addition to histologic features, included tumor circumscription, and infiltration into adjacent structures, (summarized in Arner et al 11 ).…”

Section: Tumor Gradingmentioning

confidence: 99%

Advances and controversies in grading and staging of renal cell carcinoma

2009

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Despite the considerable progress made in our understanding of the pathogenesis, genetics, and pathology of renal cell carcinoma (RCC), difficulties remain relating to the prediction of clinical outcome for individual cases. Although there is evidence to show that high-grade tumors have a poorer prognosis when compared to those of low grade, debate remains regarding the predictive value of grading, especially for those tumors classified into the intermediate grades. Numerous composite morphologic and nuclear grading systems have been proposed for RCC and although that of the Fuhrman classification have achieved widespread usage, the validity of the grading criteria of this classification has been questioned. In addition, there are few studies that have attempted to validate the Fuhrman system for RCCs beyond that of the clear cell subtype. Recent studies have indicated that grading of papillary RCC should be based on nucleolar prominence alone and that the components of the Fuhrman grading classification do not provide prognostic information for chromophobe RCC. Independent of tumor grade, the prognostic importance of tumor stage for RCC is well recognized. The Union Internationale Contre le Cancer/American Joint Committee for Cancer Staging and End Results Reporting TNM staging system is now in its sixth edition (2002) and recent refinements have focused on defining size cut points that will identify apparently localized tumors that will develop recurrence and/or metastases despite attempted curative surgery. In parallel with these studies it has been shown that infiltration of the renal sinus is an important prognostic factor, being observed in almost all tumors 47 cm in diameter. Questions remain as to the appropriate stratification of regional extension of RCC, as defined in the T3 tumor-staging category. Recent modifications to this category have been suggested combining the level of infiltration of the venous outflow tract with the presence or absence of infiltration of the adrenal gland and/or perirenal fat. Similarly, the utility of classifying lymph node involvement by tumor is debated, although it is well recognized that lymph node infiltration is associated with a poor prognosis. Although the current TNM classification does provide useful prognostic information it would appear that further modifications are justified to enhance the predictive value of staging for RCC.

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“…Flamming (1882) and Waldeyer (1888) were the first investigators to describe the histomorphological conception of "cell division, mitosis and cell proliferation" in human malignancies [8]. In different malignant tumors, pathologists have found a correlation between the mitosis rate determined in histological specimens and the individual clinical course of patients with neoplasias [10,18].…”

mentioning

confidence: 99%