Significance of Macroscopic Tumor Necrosis as a Prognostic Indicator for Renal Cell Carcinoma

Lee, Sang Eun; Byun, Seok‐Soo; Oh, Jin Kyu; Chang, In Ho; Choe, Gheeyoung; Hong, Sung Kyu

doi:10.1016/j.juro.2006.06.021

Cited by 45 publications

(27 citation statements)

References 16 publications

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“…In the majority of reports (16 out of 20) there was an association between the presence of tumor necrosis and poorer prognosis including reduced overall survival [16][17][18], reduced cancer-specific survival [8,13,15,[19][20][21][22][23][24][25] and increased risk of metastases or disease recurrence [26][27][28]. The largest study relating to RCC was undertaken by Sengupta and coworkers who examined the pathology of over 3000 patients and reported an increased risk of cancer death in patients with necrosis, even after making a djustments for tumor size, grade and stage [13].…”

Section: Tumor Necrosis In Renal and Transitional Cell Malignancymentioning

confidence: 99%

“…In studies that had examined mixed histological subtypes of RCC, tumor necrosis was found to be of prognostic value only in clear cell tumors [13,19,21,24]. Indeed, necrosis has since been incorporated into an outcome prediction model for patients with clear cell RCC known as the tumor stage, size, grade and necrosis (SSIGN) score [8].…”

Section: Tumor Necrosis In Renal and Transitional Cell Malignancymentioning

confidence: 99%

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The Prognostic Value of Histological Tumor Necrosis in Solid Organ Malignant Disease: A Systematic Review

Richards¹,

et al. 2011

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There is now a substantial body of evidence confirming the prognostic value of tumor necrosis in solid organ malignant disease. There are consistent associations between necrosis and the presence of other high-risk tumor characteristics but the survival impact appears to be independent of pathological stage. We propose that relationships with the host inflammatory response, both local and systemic, may explain the influence of tumor necrosis on cancer outcome.

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Section: Tumor Necrosis In Renal and Transitional Cell Malignancymentioning

confidence: 99%

Section: Tumor Necrosis In Renal and Transitional Cell Malignancymentioning

confidence: 99%

The Prognostic Value of Histological Tumor Necrosis in Solid Organ Malignant Disease: A Systematic Review

Richards¹,

et al. 2011

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“…Patard et al maintain that the histological subtype was a less powerful prognostic factor than the stage of the RCC (35). Tumor necrosis is also a widely accepted prognostic factor in RCC (36). Finally, the clinical prognostic factors include ECOG performance status, patient symptoms, cachexia and anemia (37).…”

Section: Discussionmentioning

confidence: 99%

Overexpression of IL-32 is a novel prognostic factor in patients with localized clear cell renal cell carcinoma

et al. 2011

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Abstract. ) is a proinflammatory cytokine that acts as a significant pathogenetic factor in various diseases and malignancies. However, the clinical effect of IL-32 expression in renal cell carcinoma (RCC) has not previously been investigated. The aim of the present study was to examine the significance of IL-32 overexpression in localized clear cell RCC (CCRCC). We examined 112 patients with localized CCRCC who underwent nephrectomy. The clinicopathological data were obtained by retrospective review and the expression levels of IL-32 were studied by immunohistochemistry. Tumors were classified according to staining intensity (0, no staining intensity; 1, weak; 2, intermediate; 3, strong). The cases with staining intensities from 0 to 2 comprised the IL-32 low-expression group (LEG), whereas those with a staining intensity of 3 comprised the IL-32 high-expression group (HEG). Correlations between IL-32 expression and clinicopathological parameters were determined. Staining intensities were determined for all cases as follows: 26 cases (23.2%) (score 0), 43 cases (38.4%) (score 1), 31 cases (27.7%) (score 2) and 12 cases (10.7%) (score 3). IL-32 HEG exhibited a higher recurrence rate compared to the IL-32 LEG (50 vs. 13%, P= 0.001). For survival rates, the 5-year recurrence-free survival (RFS), disease-specific survival (DSS) and overall survival (OS) rates were lower in the IL-32 HEG group compared with the IL-32 LEG group (RFS, P= 0.001; DSS, P<0.001; OS, P= 0.026, respectively). Univariate analyses revealed that Fuhrman nuclear grade and a high IL-32 expression were significant prognostic factors for predicting RFS, DSS and OS in CCRCC, whereas multivariate analyses indicated that Fuhrman nuclear grade and high IL-32 expression were still independent risk factors. In conclusion, IL-32 overexpression was associated with high recurrence rates and low RFS, DSS and OS, indicating that it may be a novel prognostic factor for predicting outcomes in patients with CCRCC.

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“…In a Mayo Clinic study, histologic necrosis was associated with twice the risk of death from RCC compared with patients without necrosis [51]. Several studies also reported that the presence and extent of histologic necrosis in RCC were independent predictors of survival in localized but not metastatic cases [62,63]. Therefore, two outcome prediction models, SSIGN (stage, size, grade, necrosis) from the Mayo Clinic, and the postoperative outcome nomogram from the Memorial Sloan Kettering Cancer Center, have incorporated tumor necrosis in their models [27,64].…”

Section: Tumor Necrosismentioning

confidence: 97%

The changing face of renal cell carcinoma pathology

Aydın¹,

Zhou

2008

Curr Oncol Rep

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Significance of Macroscopic Tumor Necrosis as a Prognostic Indicator for Renal Cell Carcinoma

Abstract: Our results suggest that macroscopic tumor necrosis may be a reliable prognostic indicator for nonmetastatic clear cell renal cell carcinoma which should routinely be examined for during pathological analysis.

Cited by 45 publications

References 16 publications

The Prognostic Value of Histological Tumor Necrosis in Solid Organ Malignant Disease: A Systematic Review

The Prognostic Value of Histological Tumor Necrosis in Solid Organ Malignant Disease: A Systematic Review

Overexpression of IL-32 is a novel prognostic factor in patients with localized clear cell renal cell carcinoma

The changing face of renal cell carcinoma pathology

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