Prognostic Significance of Tumor Thrombus Level in Patients With Renal Cell Carcinoma and Venous Tumor Thrombus Extension. Is All T3b the Same?

Moinzadeh, Alireza; Libertino, John A.

doi:10.1097/01.ju.0000108842.27907.47

Cited by 195 publications

(119 citation statements)

References 13 publications

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“…98 In subsequent studies conflicting results as to the prognostic significance of this classification have been reported, with some studies validating the classification, [99][100] whereas others have shown that the level of tumor thrombus beyond the renal vein does not influence survival. [101][102][103][104][105] To predict the outcome more accurately in locally advanced disease, additional parameters have been proposed to further stratify tumors showing vascular invasion. In particular, the poor prognosis associated with perirenal fat, adrenal and Gerota's fascia infiltration has led to the incorporation of those features into a proposed modification of pT3-4 criteria.…”

Section: Regional Spread Of Tumor (Tnm Category T3)mentioning

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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Section: Regional Spread Of Tumor (Tnm Category T3)mentioning

confidence: 99%

Advances and controversies in grading and staging of renal cell carcinoma

2009

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“…Therefore, detailed preoperative staging is necessary for proper surgical planning [13]. A survival rate of patients with RCC depends on local tumor expansion, as well as the level of venous involvement and the presence of distant metastases [14,15].…”

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confidence: 99%

Venous spread of renal cell carcinoma: MDCT

et al. 2006

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“…[5][6][7] Moreover, controversy exists regarding the prognostic significance of the cranial extension of venous tumor thrombus (VTT), the location of extrarenal extension (ERE), and the concomitant presence of both pathologic features. [8][9][10][11][12][13] By examining the prognostic features and cancerspecific outcomes of a large cohort of patients treated within the past 15 years for RCC at a tertiary referral center, this study seeks to reassess and suggest possible improvements to the 2002 AJCC pT3 classification of RCC.…”

Section: Resultsmentioning

confidence: 99%

Redefining pT3 renal cell carcinoma in the modern era

Margulis

Tamboli

Matin

et al. 2007

Cancer

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Tissue preparation has recently been utilized for detection of neuronal activation in multiple non‐BOLD based functional MRI studies to eliminate vascular contamination. However, undesired signal change could still occur in such systems due to the concentration change of dissolved O2 upon tissue activation. To estimate the impact of such effects, the O2 concentration distribution and the consequent susceptibility field in tissue‐solution systems were simulated with various tissue geometries and experimental parameters. Our results indicate that substantial signal change between the resting and activated states could potentially be induced by the O2 effect in highly oxygenated solutions, and thus caution should be taken in interpreting any signal change observed in such experiments. Magn Reson Med, 2011. © 2010 Wiley‐Liss, Inc.

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Prognostic Significance of Tumor Thrombus Level in Patients With Renal Cell Carcinoma and Venous Tumor Thrombus Extension. Is All T3b the Same?

Cited by 195 publications

References 13 publications

Advances and controversies in grading and staging of renal cell carcinoma

Advances and controversies in grading and staging of renal cell carcinoma

Venous spread of renal cell carcinoma: MDCT

Redefining pT3 renal cell carcinoma in the modern era

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