Impact of Microvascular Invasion and Tumor Necrosis on the Prognosis of Korean Patients with pT1b Renal Cell Carcinoma

Kwon, Se Yun; Lee, Jun Nyung; Kim, Bum Soo; Ko, Young Hwii; Song, Phil Hyun; Kim, Hyun Tae; Kim, Tae‐Hwan; Yoo, Eun Sang; Choi, Gyu–Seog; Kim, Bup Wan; Kwon, Tae Gyun

doi:10.1159/000366138

Cited by 6 publications

(4 citation statements)

References 28 publications

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“…Microvascular invasion and microvascular density have been shown to have a significant impact on metastasis, recurrence risk, and survival (21). In the study of Kwon et al, MVI and tumor necrosis in pT1b RCC were found to be independent prognostic factors from tumor stage (22). Bedke et al study showed that MVI was found to be a weak prognostic factor correlating with tumor stage, Fuhrman nuclear grade and sarcomatoid differentiation in RCC (23).…”

Section: Discussionmentioning

confidence: 99%

The Effect Of Beclin 1, P53 Mutation, Ki-67 Proliferation İndex, Tumor Necrosis and Microvascular İnvasion On Prognosis İn Renal Cell Carcinomas and Their Relationship With Known Prognostic Parameters

Seçinti

Akincioglu

Kandemir

2021

Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi

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Objective:The aim of this study was to help identify new prognostic markers in renal cell carcinomas (RCC), to show the role of autophagy in the pathogenesis of RCC and to shed light on new treatment modalities in RCC.Material and Methods: Clinicopathological stages, tumor necrosis and microvascular invasion (MVI) were determined retrospectively and Beclin-1, Ki-67 and p53 were studied immunohistochemically.Results: Tumor necrosis, MVI, Ki-67, and p53 in RCCs were positively correlated with Fuhrman nuclear grade and pathologic tumor stage, while Beclin-1 was only associated with nuclear grade. MVI and Ki-67 were associated with distant organ and lymph node metastasis. Ki-67 and necrosis correlated positively with p53 and Beclin-1 expression, but not with MVI. Beclin-1 were positively correlated necrosis, but not with p53 and MVI. p53, Ki-67 and MVI were negatively correlated with survival, while the effect of Beclin -1 and necrosis on survival couldn't be demonstrated. Conclusion:Ki-67, p53, and MVI in RCCs are prognostic parameters with effects on survival. Although Beclin-1 was not a prognostic parameter associated with survival, its expression in tumor tissue was found to be increased. At the same time, there is less staining in non-tumor renal parenchyma. Beclin-1 is a marker of autophagy and is thought to be involved in RCC pathogenesis rather than its prognostic significance.

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Section: Discussionmentioning

confidence: 99%

The Effect Of Beclin 1, P53 Mutation, Ki-67 Proliferation İndex, Tumor Necrosis and Microvascular İnvasion On Prognosis İn Renal Cell Carcinomas and Their Relationship With Known Prognostic Parameters

Seçinti

Akincioglu

Kandemir

2021

Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi

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“…Another recent probability assessment study showed that tumor aggressiveness exhibited proportional increases of 18%, 24%, and 29% in the likelihood of aggressive histology for 2, 3, and 4 cm RCCs (27). A different study suggested that routine follow-up periods for earlier detection of metastasis or recurrence until 12 years would enable timely interventive treatment to improve survival outcomes, particularly in cases of small tumor burden (28). Patients lost to follow-up reported poor prognostic outcomes (29) and greater tumor burdens, and more progressive metastatic states showed higher tumor heterogeneity in RCC (16).…”

Section: Discussionmentioning

confidence: 99%

Retrospective Multicenter Long-Term Follow-up Analysis of Prognostic Risk Factors for Recurrence-Free, Metastasis-Free, Cancer-Specific, and Overall Survival After Curative Nephrectomy in Non-metastatic Renal Cell Carcinoma

et al. 2019

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We evaluated prognostic risk factors of recurrence-free survival (RFS), metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival (OS) outcomes in patients with non-metastatic renal cell carcinoma (nmRCC) after curative nephrectomy during long-term follow-up. The medical records of 4,260 patients with nmRCC who underwent curative nephrectomy between 2000 and 2012 from five Korean institutions and follow-up after postoperative 1 month until December 2017 were retrospectively analyzed for RFS, MFS, OS, and CSS. During the median 43.86 months of follow-up, 342 recurrences, 127 metastases, and 361 deaths, including 222 cancer-specific deaths, were reported. In addition to the unreached median survival of RFS and MFS, the median OS and CSS times were 176.75 and 227.47 months, respectively. Multivariable analyses showed that nephrectomy type (laparoscopy vs. open), pathological T stages, and nuclear grade were common significant risk factors for survival, and the baseline ASA, hemoglobin, and pathological N stage were common factors only for RFS, OS, and CSS (p < 0.05). Further, tumor necrosis for MFS; platelet count, extent (partial vs. radical) of surgery, and lymphovascular invasion for RFS; baseline diabetes, hypertension, age, body mass index, extent of surgery, and pathological sarcomatoid differentiation for OS; and baseline diabetes, hypertension, body mass index, and pathological sarcomatoid differentiation for CSS were additionally significant risk factors (p < 0.05). RFS, MFS, OS, and CSS were significantly different depending on the pathological T stages (p < 0.05). In conclusion, this large-numbered, long-term follow-up study revealed significant factors affecting the survival of patients with nephrectomized nmRCC.

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“…In this situation, RN is the preferred treatment strategy. Furthermore, multiple researchers have shown that MVI is an important factor in the prognosis of RCC (4)(5)(6). The diagnosis of MVI mainly based on histopathological analysis.…”

Section: Introductionmentioning

confidence: 99%

A diagnostic test of three-dimensional magnetic resonance elastography imaging for preoperative prediction of microvascular invasion in patients with T1 stage clear cell renal carcinoma

Zhang¹,

Wen²,

Chen³

et al. 2023

Transl Androl Urol

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Background: Detection of microvascular invasion (MVI) of kidney tumors is important for selecting the optimal therapeutic strategy. Currently, the prediction of MVI lacks an accurate imaging biomarker.This study evaluated the performance of three-dimensional (3D) magnetic resonance elastography (MRE) imaging in predicting microvascular invasion (MVI) of T1 stage clear cell renal carcinoma (ccRCC).Methods: In this prospective study, we conducted pre-surgical imaging with a clinical 3.0 T magnetic resonance imaging (MRI) system. Firstly, 83 consecutive patients were enrolled in this study. A 3D MRE stiffness map was generated and transferred to a post-processing workstation. Contrast-enhanced computed tomography (CT) was conducted to calculate the tumor enhancement ratio. The presence of MVI was evaluated by histopathological analysis and graded according to the risk stratification based upon the number and distribution. The mean stiffness and CT tumor enhancement ratio was calculated for tumors with or without MVI. The diagnostic performance [sensitivity, specificity, positive predictive value, negative predictive value, area under the curve (AUC)] and independent predicting factors for MVI were investigated.Results: Finally, A total of 80 patients (aged 46.7±13.2 years) were enrolled, including 22 cases of tumors with MVI. The mean MRE stiffness of kidney parenchyma and kidney tumors was 4.8±0.2 and 4.5±0.7 kPa, respectively. There was significant difference in the mean MRE stiffness between tumors with MVI (5.4±0.6 kPa) and tumors without MVI (4.1±0.3 kPa) (P<0.05). The sensitivity, specificity, positive predictive value, negative predictive value, and the AUC for mean stiffness in the prediction of MVI were 100%, 75%, 63%, 96%, and 0.87 [95% confidence interval (CI): 0.72, 0.94], respectively. The corresponding values for the CT tumor enhancement ratio were 90%, 80%, 63%, 96%, and 0.88 (95% CI: 0.71, 0.93), respectively. The odds ratio (OR) value for MRE tumor stiffness and CT kidney tumor enhancement ratio in the prediction of MVI was 2.9 (95% CI: 1.8, 3.7) and 1.2 (95% CI: 1.0, 1.7), respectively (P>0.05).Conclusions: 3D MRE imaging has promising diagnostic performance for predicting MVI in T1 stage ccRCC, which may improve the reliability of surgical strategy selection with T1 stage ccRCC.

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Impact of Microvascular Invasion and Tumor Necrosis on the Prognosis of Korean Patients with pT1b Renal Cell Carcinoma

Cited by 6 publications

References 28 publications

The Effect Of Beclin 1, P53 Mutation, Ki-67 Proliferation İndex, Tumor Necrosis and Microvascular İnvasion On Prognosis İn Renal Cell Carcinomas and Their Relationship With Known Prognostic Parameters

The Effect Of Beclin 1, P53 Mutation, Ki-67 Proliferation İndex, Tumor Necrosis and Microvascular İnvasion On Prognosis İn Renal Cell Carcinomas and Their Relationship With Known Prognostic Parameters

Retrospective Multicenter Long-Term Follow-up Analysis of Prognostic Risk Factors for Recurrence-Free, Metastasis-Free, Cancer-Specific, and Overall Survival After Curative Nephrectomy in Non-metastatic Renal Cell Carcinoma

A diagnostic test of three-dimensional magnetic resonance elastography imaging for preoperative prediction of microvascular invasion in patients with T1 stage clear cell renal carcinoma

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