Prognostic assessment of nonmetastatic renal cell carcinoma: a clinically based model

Yaycıoğlu, Özgür; Roberts, William W.; Chan, Theresa Y.; Epstein, Jonathan I.; Marshall, Fray F.; Kavoussi, Louis R.

doi:10.1016/s0090-4295(01)01207-9

Cited by 126 publications

(75 citation statements)

References 14 publications

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“…Several nomograms have been developed for localized and metastatic disease using factors such as histology, stage, symptoms, performance status (PS), and tumor size (Table 3) [36,[65][66][67][68][69][70][71][72][73][74][75][76]. In 2001, Yaycioglu et al [65] developed a prognostic model independent of pathological stage.…”

Section: Prognostic Schemamentioning

confidence: 99%

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Tumor Biology and Prognostic Factors in Renal Cell Carcinoma

2011

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In the past 15 years, there has been an increased understanding of the tumor biology of renal cell carcinoma (RCC). The identification of vascular endothelial growth factor (VEGF), its related receptor (VEGFR), and the mammalian target of rapamycin as dysregulated signaling pathways in the development and progression of RCC has resulted in the rational development of pharmaceutical agents capable of specifically targeting key steps in these pathways. Clinical trials have demonstrated survival benefit with these agents, particularly in clear cell RCC patients. However, metastatic RCC will progress in all patients, resulting in a critical need to determine patient risk and optimize treatment. The goal of this article is to highlight the significant breakthroughs made in understanding the critical genetic alterations and signaling pathways underlying the pathogenesis of RCC. The discovery of prognostic factors and development of comprehensive nomograms to stratify patient risk and predictive biomarkers to facilitate individualized treatment selection and predict patient response to therapy also are reviewed. The Oncologist 2011;16(suppl 2):4 -13

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Section: Prognostic Schemamentioning

confidence: 99%

“…In 2001, Yaycioglu et al [65] developed a prognostic model independent of pathological stage. The Kattan nomogram includes histologic type, tumor size, TNM classification, and clinical presentation to estimate the probability of recurrence-free survival after 5 years of follow-up [66].…”

Section: Prognostic Schemamentioning

confidence: 99%

Tumor Biology and Prognostic Factors in Renal Cell Carcinoma

2011

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“…It has been known as one of the most important prognostic factors in RCC. 25 Among the four tumor stages, T4 stage was prominently significant in Cox proportional hazard analysis (P < 0.001, HR17.74, 95% CI 3.371-93.344) when compared with T1 stage. Other stages, T2 (P = 0.077, HR 3.43 95% CI 0.873-13.479) and T3 (P = 0.856, HR 3.755, 95% CI 0.036-15.675), were not statistically different from T1 stages.…”

Section: Discussionmentioning

confidence: 89%

Localized non‐conventional renal cell carcinoma: Prediction of clinical outcome according to histology

et al. 2013

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Abbreviations & Acronyms ASA = American Society of Anesthesiologists BMI = body mass index CD = collecting duct CRCC = clear cell type renal cell carcinoma CSS = cancer-specific survival HR = hazard ratio LVI = invasion into lymphovascular MTSC = mucinous tubular and spindle cell NCRCC = non-conventional clear cell renal cell carcinoma Nx = nephrectomy OS = overall survival RCC = renal cell carcinoma RFS = recurrence-free survival SD = sarcomatoid differentiation SFI = involvement of sinus fat Xp11.2t = Xp11. Objective: A wide variety of parameters have been investigated in the prognostic significance of non-conventional clear cell renal cell carcinoma. Aim of the present study was to compare its clinical outcome and to determine the independent prognostic factors according to the histology. Methods: This retrospective study enrolled localized non-conventional clear cell renal cell carcinomas (T1a-T4N0M0), including Xp11.2 translocation (Xp11.2t), all surgically treated in a single institution between 1988 and 2011. The study statistically analyzed the clinicopathological parameters to compare the prognostic outcomes among the different histological subtypes of non-conventional clear cell renal cell carcinoma and to define any independent prognostic factors. Results: A total of 374 cases were examined, including 126 papillary (33.7%), 164 chromophobe (43.9%), eight collecting duct (2.1%), 40 unclassified (10.7%), 16 Xp11.2t (4.3%), seven mucinous tubular and spindle cell (1.8%) renal cell carcinomas and 13 oncocytomas (3.5%). The mean follow up was 56.4 months, with s mean tumor size of 4.9 ± 3.4 cm. The 4-year recurrence-free survival, overall survival and cancer-specific survival were inversely related to the increase of pathological T stages (P < 0.001). For histological type other than 13 oncocytomas and seven mucinous tubular and spindle cell renal cell carcinomas, the chromophobe showed the best prognosis of survival, followed by papillary, Xp11.2t, unclassified and collecting duct renal cell carcinomas, in this order. All survival rates were significantly different, as according to the histology (P = 0.009). The significant prognostic factors were preoperative body mass index (hazard ratio 0.76), serum albumin (hazard ratio 0.64), T stage (hazard ratio 2.28), the sarcomatoid differentiation (hazard ratio 33.45) and lymphovascular invasion (hazard ratio 12.40) in pathology (P < 0.05). Conclusions: Different non-conventional clear cell renal cell carcinoma subtypes have significantly different clinical characteristics of prognosis with many suggestive predictive factors of survival.

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“…Other prognostic models rely on clinical variables only to identify high risk patients, such as the models proposed by Yaycioglu [23] and Cindolo [23,24]. Clinical models are beneficial in circumstances where the complete pathological staging is not readily available, as in the example of tissue obtained through minimally invasive approaches are performed.…”

Section: Prognostic Models In Rccmentioning

confidence: 99%