Prognostic variables and nomograms for renal cell carcinoma

Abstract

Abstract:The term renal cell carcinoma (RCC) is used to describe a heterogeneous group of tumors that vary histologically, genetically and molecularly. Extensive research has been conducted to identify characteristics that predict outcomes among patients with RCC. In addition to histological subtype these include tumor size, patient age, mode of presentation and various hematological indices, among others. Several groups have incorporated these clinical and pathological features into nomograms which help the clinician better define individual patient prognosis and direct the optimum therapeutic approach. In the present article we review these prognostic variables and nomograms for RCC.

Selected morphologic features influencing the prognosis of conventional renal cell carcinomas co-expressing P53 and MDM2

“…The best established morphologic prognostic factors include tumor type and stage, presence of sarcomatoid components and for some subtypes, histologic grade [1]. The grading system for CCRCC has been revised recently [8], with necrosis being defined as an additional poor prognostic factor.…”

“…This increased interest is partly due to the introduction of new methods of treatment, such as targeted drugs or alternative surgery. Prognostic factors of CCRCC include stage, grade and histologic type; many biomarkers have been studied, but few of them have yet become of any practical importance [1,2]. TP53, possibly the best known tumor suppressor gene, is mutated in over 50% of human cancers, and in some cases (e.g.…”

Molecular Portrait of Clear Cell Renal Cell Carcinoma: An Integrative Analysis of Gene Expression and Genomic Copy Number Profiling

“…According to the canonical classification of ccRCC (Flanigan et al, 2011), the Furhman nuclear grade is one of the most important parameters for RCC prognosis prediction (Nese et al, 2009), together with stage, age, tumor position and size, necrosis and other few molecular biomarkers (e.g., CA9). Noticeably, recent grade-dependent proteomic characterization reported that MYC, HIF-1 and p53 are the major hubs of the network obtained analyzing formalin-fixed paraffin embedded ccRCC tissues (Perroud et al, 2009).…”

“…Based on histology, RCC can be classified into several subtypes, i.e., clear cell (80% of cases), papillary (10%), chromophobe (5%) and oncocytoma (5%), each one characterized by specific histopathological features, malignant potential and clinical outcome (Cohen & McGovern, 2005). Patient stratification is normally achieved using prognostic algorithms and nomograms based on multiple clinico-pathological factors such as TNM stage, Fuhrman nuclear grade, tumor size, performance status, necrosis and other hematological indices (Flanigan et al, 2011), although the most efficient predictors of survival and recurrence are based on nuclear grade alone (Nese et al, 2009). As recently reviewed by Brannon et al , a finer RCC subtype classification could be obtained exploiting the vast amount of genomic and transcriptional data that have been presented in numerous studies.…”

Expressão de Ciclina D1 em Carcinoma de Células Renais

“…Tamanho tumoral é um componente-chave no sistema de estadiamento TNM, além de ser um dos mais importantes indicadores de prognóstico, devendo ser bem analisado (VOLPE e JEWETT, 2005;POLCARI et al, 2011). Definimos os pontos de corte para análise do tamanho tumoral (≤ 4,0 cm, > 4,0 e ≤ 7,0cm, > 7,0 cm) com base no estadiamento TNM (Anexo B).…”