Arroyo-López R, Aragón-Tovar R, López-Verdugo JF, Castillo-Chavira G, Zavala-Pompa A, Vargas-Valtierra P

Language: Spanish
References: 20
Page: 277-280
PDF size: 493.64 Kb.

ABSTRACT

Objective: To determine if there was a size, grade, stage or histopathological correlation with multifocality in cancer of the kidney.
Materials and methods: Histopathological results of urology service patients that underwent radical nephrectomy between November 1 and October 31, 2008, were reviewed. Pathology stage, tumor grade, histological subtype and tumor size were evaluated and findings were correlated with multifocality in kidney cancer.
Results: Mean kidney tumor size was 6.93 cm. In relation to histological subtype, 41 patients presented with clear cells (93.1%), 2 patients with papillary cells (4.54%) and 1 patient with chromophobe cells (2.27%). With respect to grade, 3 patients had Fuhrman 1 (6.81%), 22 patients had Fuhrman 2 (50%), 10 patients had Fuhrman 3 (22.72%) and 9 patients had Fuhrman 4 (20.45%). In relation to stage, 6 patients presented with T1a (13.63%), 18 patients with T1b (40.90%), 17 patients with T2 (38.63%), 1 patient with T3a (2.27%), 1 patient with T3b (2.27%) and 1 patient with T4 (2.27%). Multifocality was observed in 15 specimens (34%). Pearson correlation was applied to multifocality and the other variables resulting in a Pearson value of 0.04, 0.18, 0.10 and 0.12 for histological subtype, Fuhrman grade, size and TNM stage, respectively.
Conclusions: There was no correlation between histological subtype, Fuhrman grade, size and TNM stage with multifocality in cancer of the kidney.

REFERENCES

1. Hafez KS, Fergany AF, Novick AC. Nephron sparing surgery for localized renal cell carcinoma: impact of tumor size on patient survival, tumor recurrence and TNM. J Urol 1999;162(6):1930-3.

2. Ficarra V, Galfano A, Mancini M, Martignoni G, Artibani W. TNM staging system for renal-cell carcinoma: current status and future perspectives. Lancet Oncol 2007;8(6):554-8.

3. Dimarco DS, Lohse CM, Zincke H, Cheville JC, Blute ML. Long-term survival of patients with unilateral sporadic multifocal renal cell carcinoma according to histologic subtype compared with patients with solitary tumors after radical nephrectomy. Urology 2004;64(3):462-7.

4. Baltaci S, Orhan D, Soyupek S, Bedük Y, Tulunay O, Gögüs O. Influence of tumor stage, size, grade, vascular involvement, histological cell type and histological pattern on multifocality of renal cell. J Urol 2000;164(1):36-9.

5. Ficarra V, Prayer-Galetti T, Novara G, Bratti E, Zanolla L. Tumor-size breakpoint for prognostic stratification of localized renal cell carcinoma. Urology 2004 Feb;63(2):235-9.

6. Sengupta S, Zincke H. Lessons learned in the surgical management of renal cell carcinoma. Urology 2005;66(5 Suppl):36-42.

7. Uzzo RG, Novick AC. Nephron sparing surgery for renal tumors: indications, techniques and outcomes. J Urol 2001;166(1):6-18.

8. Marszalek M, Ponholzer A, Brössner C, Wachter J, Maier U. Elective open nephron-sparing surgery for renal masses: single-center experience with 129 consecutive patients. Urology 2004;64(1):38-42.

9. Sutherland SE, Resnick MI, Maclennan GT, Goldman HB. Does the size of the surgical margin in partial nephrectomy for renal cell cancer really matter? J Urol 2002;167(1):61-4.

10. Mullerad M, Kastin A, Adusumilli PS, Moskovitz B, Sabo E. Comparison of nephron-sparing surgery in central versus peripheral renal tumors. Urology 2005;65(3):467-72.

11. Zorn KC, Gong EM, Orvieto MA, Gofrit ON, Mikhail AA. Comparison of laparoscopic radical and partial nephrectomy: effects on long-term serum creatinine. Urology 2007;69(6):1035-40.

12. Lohse CM, Cheville JC. A review of prognostic pathologic features and algorithms for patients treated surgically for renal. Clin Lab Med 2005;25(2):433-64.

13. John MH. Surgical management of low-stage renal cell carcinoma: technology does not supersede biology. Urology 2006;67(6):1175-80.

14. Navai N, Ramos P, Zhao LC, Meeks JJ, Nadler RB. Why not partial nephrectomy? Urology 2008;72(2):243.

15. Ukimura O, Haber GP, Remer EM, Gill IS. Laparoscopic partial nephrectomy for incidental stage pT2 or worse tumors. Urology 2006;68(5):976-82.

16. Steinberg AP, Kilciler M, Abreu SC, Ramani AP, Ng C. Laparoscopic nephron-sparing surgery for two or more ipsilateral renal tumors. Urology 2004 Aug;64(2):255-8.

17. Walsh, Retik, Vaughan, Wein, Campbell. Urología. 8ª ed. Tomo 4. Editorial Médica Panamericana. 2006. pp. 2926-2965.

18. Kletscher BA, Qian J, Bostwick DG, Andrews PE, Zincke H. Prospective analysis of multifocality in renal cell carcinoma: influence of histological pattern, grade, number, size, volume and deoxyribonucleic acid ploidy. J Urol 1995;153(3 Pt 2):904-6.

19. Whang M, O’Toole K, Bixon R, Brunetti J, Ikeguchi E. The incidence of multifocal renal cell carcinoma in patients who are candidates for partial nephrectomy. J Urol 1995;154(3):968-70.

20. Gohji K, Hara I, Gotoh A, Eto H, Miyake H, Multifocal renal cell carcinoma in Japanese patients with tumors with maximal diameters of 50 mm or less. J Urol 1998;159(4):1144-7.