Prognostic Significance of Microvascular Invasion in Localized Renal Cell Carcinoma

Sevinç, Murat; Kırkalı, Ziya; Yörükoğlu, Kutsal; Mungan, Uğur; Sade, Murat

doi:10.1159/000020370

Cited by 48 publications

(4 citation statements)

References 24 publications

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“…Furthermore, it is well established that RCC is characterized by abundant neovascularization, and metastases are more frequently found in patients with highly vascularized primary RCC. Microvascular invasion is explained by the existence of tumor cells in the walls of microvessels with endothelial cells that are locally damaged from the actions of tumor cells [20,21]. Van Poppel et al [22] analyzed the prognostic relevance of the presence of microscopic vascular invasion in clinically localized RCC, and they showed that microvascular invasion independently predicted tumor progression.…”

Section: Discussionmentioning

confidence: 99%

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

Kwon¹,

Lee²,

Kim³

et al. 2014

Urol Int

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Objectives: To evaluate prognostic factors in pT1b renal cell carcinoma (RCC) patients for which no specific studies have been conducted on. Methods: The data of 270 patients diagnosed with pT1bN0M0 RCC at 2 institutions between January 1998 and June 2010 were retrospectively analyzed. Univariate and multivariate analyses using Cox proportional hazard models were used to identify pathologic and clinical factors that influenced prognosis. Five-year recurrence-free survival and cancer-specific survival were analyzed using the Kaplan-Meier method. Results: The median follow-up period was 55.5 months, and the mean patient age was 55.2 years (range: 26-80). There were 12 cancer-related deaths, and tumor recurrence was noted in 22 patients between 8 and 120 months after surgery. Sites of metastases included the lung in 13 patients, bone in 5 patients, and other sites in 4 patients. Five-year recurrence-free survival and cancer-specific survival rates were 91.2 and 93.5%, respectively. Multivariate analyses revealed that the presence of microvascular invasion and tumor necrosis independently predicted prognosis. Conclusions: Microvascular invasion and tumor necrosis were found to be independent prognostic factors in pT1b RCC. This result will help urologists to provide patients with more accurate prognoses, and patients with confirmed microvascular invasion and tumor necrosis will require closer follow-up.

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Section: Discussionmentioning

confidence: 99%

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

Kwon¹,

Lee²,

Kim³

et al. 2014

Urol Int

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show abstract

“…It is well known that RCC is characterized by abundant neovascularization, and metastases have been more frequently found in patients with highly vascularized primary RCC [21]. Microvascular invasion is explained by the existence of tumor cells in the walls of the microvessels, along with endothelial cells that are locally damaged due to the tumor cells [13,16]. …”

Section: Discussionmentioning

confidence: 99%

The Prognostic Factors for Patients with pT1a Renal Cell Carcinoma

et al. 2010

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PurposeAlthough the prognosis of patients with pT1a stage renal cell carcinoma (RCC) is generally good, some of these patients show distant metastasis. In this study, we intended to identify the perioperative and pathologic prognostic factors for patients with pT1a stage RCC.Materials and MethodsA total of 93 patients who were diagnosed with pT1aN0M0 RCC between January 1995 and December 2004 were included. All the patients underwent radical (n=63, 67.7%) or partial (n=30, 32.3%) nephrectomy by a single surgeon. Preoperative data [age, sex, body mass index (BMI), and the presence of symptoms], follow-up duration, surgical methods, and pathological parameters (tumor size, tumor location, histologic type, Fuhrman's nuclear grade and the presence of microvascular invasion, hemorrhage, necrosis, calcification, and a cystic component in the tumor) were retrospectively analyzed to identify which of these were prognostic factors for pT1a RCC.ResultsThe patients' mean age was 55.0±11.4 years and the mean follow-up duration was 63.6±31.1 months. The 5-year cancer-specific survival rate and the 5-year recurrence- free survival rate were 100% and 88.1%, respectively. Nine patients (9.7%) showed distant metastasis, but local recurrence was not shown. Fuhrman's nuclear grade (p=0.040, OR=5.147), microvascular invasion (p=0.011, OR=13.500), and tumor necrosis (p<0.001, OR=26.000) had a significant impact on distant metastasis in the univariate analysis. The multivariate analysis subsequently showed that microvascular invasion (p=0.033, OR=17.947) and tumor necrosis (p=0.002, OR=15.922) were independent prognostic factors.ConclusionsMicrovascular invasion and tumor necrosis are the prognostic factors for patients with pT1a RCC.

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“…Добре відомо, що навіть мікроскопічна судинна інвазія є несприятливим прогностичним фактором [24,25]. Таким чином, поганий прогноз також очікується у пацієнтів з макроскопічним тромбом у великих судинах.…”

Section: прогнозunclassified

Рак Нирки З Метастатичним Тромбозом Нижньої Порожнистої Вени – Сучасний Стан Проблеми Та Перспективи Розвитку

Тодуров,

Ковтун,

Загрійчук

et al. 2024

APN

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Вступ. Даний огляд присвячений аналізу рівнів поширення тромбу у нижній порожнистій вені та його вплив на прогноз виживаності при раку нирки з метастатичним тромбозом НПВ. Мета. Проаналізувати в оглядовій статті вплив на прогноз рівня ураження нижньої порожнистої вени (НПВ) при нирково-клітинній карциномі (НКК) та дослідити сучасні принципи лікування НКК з пухлинним тромбозом НПВ. Матеріали і методи. Проведено літературний пошук та проаналізовано відповідні статті. Відносно недавні роботи, а також великі серії або роботи з експертних центрів включені до списку літератури. Результати та їх обговорення. Пухлинний венозний тромбоз при НКК є серйозною та частою проблемою сьогодення, пацієнти з такою патологією мають поганий прогноз. Хоча успішне видалення пухлинного тромбу в нирковій вені та нижній порожнистій вені може призвести до покращення довгострокового виживання у більш ніж половини пацієнтів, проте високий рівень тромбу є поганим прогностичним фак- тором рецидиву раку. Повна тромбектомія нижньої порожнистої вени, навіть за наявності метастазів, забезпечує кращу якість життя і може подовжити виживаність. Висновки. Хірургічне втручання – найефективніший метод лікування пацієнтів з нирково-клітинною карциномою. Необхідно докладати всіх зусиль для повного видалення тромбу з нижньої порожнистої вени. Нова таргетна (прицільна) терапія може бути перспективною в якості допоміжної терапії у цієї підгрупи пацієнтів.

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Prognostic Significance of Microvascular Invasion in Localized Renal Cell Carcinoma

Cited by 48 publications

References 24 publications

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

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

The Prognostic Factors for Patients with pT1a Renal Cell Carcinoma

Рак Нирки З Метастатичним Тромбозом Нижньої Порожнистої Вени – Сучасний Стан Проблеми Та Перспективи Розвитку

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