Renal cell carcinoma: Comparison of the tnm and robson stage groupings

Guinan, Patrick; Saffrin, Robert; Stuhldreher, David; Frank, Walter L.; Rubenstein, Marvin

doi:10.1002/jso.2930590310

Cited by 35 publications

(10 citation statements)

References 17 publications

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“…42,[76][77][78][79][80] These findings are not surprising as detailed analysis of tumor size as a continuous variable has shown that the probability of death increases with tumor size (3.51 Â for each doubling of tumor size). 81 As a consequence any arbitrary cut point will likely be significantly associated with survival providing that the sample size is sufficiently large.…”

Section: Tumor Size (Tnm Categories T1 and T2)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: Tumor Size (Tnm Categories T1 and T2)mentioning

confidence: 99%

Advances and controversies in grading and staging of renal cell carcinoma

2009

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“…Indeed, the TNM classification has been revised recently for the 1997 edition of UICC and AJCC publications [8,9]. One of the reasons that prompted the UICC and AJCC to change the 1987 TNM classification was the lack of difference in prognostic relevance between the pT1 and pT2 categories [10,11].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the 1997 tumour, nodes and metastases classification of renal cell carcinoma: experience in 172 patients

Minervini

Fontana

et al. 2000

BJU International

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“…Life expectancy has been shown to depend on tumor size, and the survival rates of tumors <5 cm, 5-10 cm, and >10 cm are 84%, 50%, and 0%, respectively (9). In 1997, the cut-off value for tumor size at T1 stage was increased from 2.5 cm to 7 cm (10).…”

Section: Discussionmentioning

confidence: 99%

The effect of tumor volume on survival in renal cell carcinoma patients

Seçil

Çullu²,

Aslan³

et al. 2012

Diagn Interv Radiol

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480R enal cell carcinoma (RCC) constitutes 85% of all primary malignant tumors arising from kidney and nearly 3% of adult cancers (1-6). Approximately 20%-30% of patients diagnosed with RCC have metastasis at the time of diagnosis (1). In patients with recurrent RCC, progression of the disease, the period of survival, and the disease process can be predicted owing to many morphological, clinical, histological, and molecular parameters (3). The prognostic markers of RCC include tumor node metastasis (TNM) stage as morphological marker; histological type, nuclear grade, tumor necrosis, and sarcomatoid change as histological markers; and factors such as adhesion molecules, molecules stimulating immune response, growth factor receptors, and molecules inducing hypoxia as molecular and genetic markers (3). Clinical and laboratory prognostic factors are represented by the following parameters: patient performance at tumor presentation, the erythrocyte sedimentation rate, thrombocyte count, as well as serum calcium, hemoglobin, and lactate dehydrogenase levels. Among these, tumor stage, grade, and patient performance are the most widely used. Many studies on molecular and cytogenetic markers have been performed but none has been found to be better than tumor stage and nuclear grade to estimate prognosis. For this reason, efforts for determining new prognostic factors that indicate the proliferation and progression of RCC still persist (2-4). Several trials have been conducted concerning the diameter of tumors in RCC; however, few trials exist regarding the tumor volume. Tumor volume calculated using three-dimensional (3D) imaging techniques is accepted as independent marker in predicting the outcome in pharyngolaryngeal, lung, and breast cancers (5). Tumor volume is the basic criterion for deciding the treatment outcome in radiotherapy (7). Measuring the volume of brain tumors allows making decision on the prognosis and treatment of the patient (8).The aim of our study was to investigate the effect of tumor volume on prognosis and the relation of tumor volume to other prognostic markers in patients with RCC. Materials and methodsThe study included 46 retrospectively assessed patients (32 males and 14 females; mean age, 58.13±10.47 years; age range, 33-81 years) who underwent surgery between January 2002 and January 2009 and received a diagnosis of RCC. Considering January 1, 2009 as the deadline, the clinical information and the last health status of all patients were obtained from the hospital information system and/or by contacting the patients or their relatives who agreed to communicate by phone. The study was approved by the local ethics committee of our institution. GENITOURINARY IMAGING ORIGINAL ARTICLE The effect of tumor volume on survival in patients with renal cell carcinomaMustafa Seçil, Neşat Çullu, Güven Aslan, Uğur Mungan, Fatma Uysal, Burçin Tuna, Kutsal Yörükoğlu MATERIALS AND METHODSThe study included 46 retrospectively assessed patients with RCC (32 males and 14 females; mean age, 58.13±10.47 years) ...

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Renal cell carcinoma: Comparison of the tnm and robson stage groupings

Cited by 35 publications

References 17 publications

Advances and controversies in grading and staging of renal cell carcinoma

Advances and controversies in grading and staging of renal cell carcinoma

Evaluation of the 1997 tumour, nodes and metastases classification of renal cell carcinoma: experience in 172 patients

The effect of tumor volume on survival in renal cell carcinoma patients

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