Survival Analysis of Pathological T3a Upstaging in Clinical T1 Renal Cell Carcinoma

Abstract

Aim: To evaluate the oncological outcomes of pathological T3a upstaging from clinical T1 renal cell carcinoma. Patients and Methods: We retrospectively studied patients who underwent radical or partial nephrectomy for clinical T1 renal tumors. Results: The median follow-up period was 44 months. At three and five years, the respective overall survival rate was 88. 7% and 82.4% in pT3a disease, 95.7% and 93.4% in pT1 (p=0.008), the cancer-specific survival rate, 93.9% and 90.8% in pT3a, 99% and 97.7% in pT1 (p=0.001), and the recurrence-free survival rate, 79.7% and 71.0% in pT3a, and 95.5 and 94.3% in pT1 (p<0.001). Conclusion: Patients with pathological T3a upstaging tumors were associated with a significantly decreased survival rate, along with a higher recurrence rate when compared to those with pathological T1 disease. 799Lai et al: Survival Αnalysis of Upstaging pT3a RCC

Comparison of oncologic outcomes between partial nephrectomy and radical nephrectomy in patients who were upstaged from cT1 renal tumor to pT3a renal cell carcinoma: an updated systematic review and meta-analysis

“…Subsequently, the analysis of fulltext articles was performed based on pre-established inclusion criteria. Finally, 12 studies [11][12][13][14][15][16][17][18][19][20][21][22] with a total of 7406 patients were included. Information on the included studies is shown in Table 1.…”

“…Among them, three studies used propensity score matching. 11,15,18 There were five studies performed in the USA, 11,15,[19][20][21] three in Korea, 12,14,17 two in China, 13,18 and one each in Canada 16 and Germany. 22 All of the trials enrolled patients diagnosed with upstage pT3 RCCa from cT1 renal tumor, who had undergone either PNx or RNx.…”

“…[8][9][10] However, previous reports on the oncological consequences of partial nephrectomy (PNx) and RNx in these patients are still conflicting. [11][12][13][14][15][16][17][18][19][20][21][22] In particular, when tumors are small but cT3 cannot be excluded from preoperative imaging studies, it is very troublesome to select PNx, although it is technically feasible. If clinicians obtain more convincing evidence on the oncological safety and efficacy of PNx in patients who are upstaged from cT1 to pT3a RCCa, it would be helpful in deciding a surgical strategy for cT1 renal tumors.…”