Santana-Ríos Z, Urdiales-Ortíz A, Camarena-Reynoso H, Fulda-Graue S, Pérez-Becerra R, Merayo-Chalico C, Hernández-Castellanos V, Saavedra-Briones D, Sánchez-Turati G, Fernández-Noyola G, Ahumada-Tamayo S, Martínez Á, Camacho-Castro A,Muñoz-Ibarra E, García-Salcido F, Cantellano-Orozco M, Morales-Montor G, Parraguirre S, Pacheco-Gahbler C

Language: Spanish
References: 22
Page: 218-224
PDF size: 424.29 Kb.

ABSTRACT

Renal cell cancer has been staged using anatomical classification. After classification controversies, the Seventh Edition of the 2010 American Joint Committee on Cancer has shown changes in accordance with pathological characteristics and prognostic factors.
Objective: To become familiar with clinical and pathological behavior of and prognostic factors in renal cell carcinoma, reclassifying them in accordance with 2010 Amercian Joint Committee on Cancer TNM staging.
Methods: A retrospective study was carried out in which one hundred cases of renal cell cancer were reviewed in patients operated on from 1997-2010. Their pathological characteristics, prognostic factors, and survival were analyzed and then reclassified according to 2010 American Joint Committee on Cancer TNM staging.
Results: Overall survival was 74% and specific cancer survival was 83%. Poor prognosis factors were: Furhman III-IV, tumor size ›10cm, vena cava involvement, adrenal gland or lymph node infiltration, and metastasis (P‹0.05). A total of 53% were reclassified with TNM 2010, 5% were understaged and 6% were overstaged.
Discussion: The importance is shown of being familiar with renal cell cancer prognostic factors and TNM staging according to the 2010 American Joint Committee on Cancer, with changes in stages T2, T3a, vascular involvement, and lymph node infiltration.
Conclusions: Prognostic factors in renal cell cancer are defined in different studies and in accordance with them, recently published staging proposals were carried out. It is necessary to be familiar with the new TNM and to reclassify patients with renal cell carcinoma.

REFERENCES

1. Igor F, Michael LB, et al. pT2 classification for renal cell carcinoma. Can its accuracy be improved? J Urol 2005;173:380-4.

2. Nese N, Gladell P Paner, et al. Renal cell carcinoma: Assessment of key pathologic prognostic parameters and patient characteristics in 47909 cases using the national cancer data base. Ann Diagn Pathol 2009;13:1-8

3. Lahm JS, Oleg S, et al. Renal cell carcinoma 2005: New frontiers in staging, prognostication and targeted molecular therapy. J Urol 2005;173:1853-62.

4. Leibovich B, Cheville J, et al. Cancer specific survival for patients with pt3 renal cell carcinoma – Can the 2002 primary tumor classification be improved? J Urol 2005;173:716-9.

5. Bukowsky R, et al. Prognostic factors for survival in metastasic renal cell carcinoma. Cancer 2009;115(10Suppl):2273-81.

6. Michaelson J, Chen LL, et al. How cancer at the primary site and in the lymph nodes contributes to the risk of cancer death. Cancer 2009;115:5095-107.

7. Thompson H, Bradley, L, et al. Should direct ipsilateral adrenal invasion from renal cell carcinoma be classified as pT3a? J Urol. 2005;173:918-21.

8. American Joint Comitee on Cancer (AJCC), 6th Ed. Cap. 43, Kidney. 2002.

9. American Joint Comitee on Cancer (AJCC), 7a Ed. Cap 43, Kidney. 2010;pp:479-486.

10. Campbell SC, Novick AC, Bukowsky. Renal Tumors. Campbell-Walsh. Urology 9a Ed. Chapter 46. Elsevier; 2007.

11. National Comprehensive Cancer Network (NCCN). Practice Guidelines in Oncology; 2010.

12. Dimashkieh H, Lohse, et al. Extranodal extension in regional lymph nodes is associated with outcome in patients with renal cell carcinoma. J Urol 2006;176:1978-82.

13. Han KR, Bui MH, et al. TNM T3a Renal cell carcinoma: adrenal gland involvement is not the same as renal fat invasion. J Urol 2003;169:899-903.

14. Klatte T, Patard JJ, et al. Prognostic impact of tumor size on pt2 renal cell carcinoma: An international multicenter experience. J Urol 2007;178:35-40;

15. Kontak JA, Campbell SC. Prognostic factors in renal cell carcinoma. Urol Clin North Am 2003;30:467-80

16. Lam JS, Patard JJ, et al. Prognostic significance of T3a renal cell carcinoma with adrenal gland involvement: An international multicenter experience. Eur Urol 2007;52:155-62.

17. Moinzadeh RJ, Mazumar M. Prognostic significance of tumor thrombus level in patients with renal cell carcinoma and venous tumor thrombus extension. Is all T3b the same? J Urol 2004;171(2Pt1):598-601.

18. Nguyen C, Campbell SC, et al. Staging of renal cell carcinoma: Past, present and future. Clin Genitourin Cancer 2006;5:190-7.

19. Pantuck AJ, Zisman A, et al. Renal cell carcinoma with retroperitoneal lymph nodes. Impact on survival and benefits of inmunotherapy. Cancer 2003;97:2995-3002.

20. Patard JJ, Kim HL, Lam JS, et al. Use of University of California-Los Angeles integrated staging system to predict survival in renal cell carcinoma: An international multicenter study. J Clin Oncol 2004;22:3316-22.

21. Phillips CK, Taneja SS, et al. The role of lymphadenectomy in the surgical management of renal cell carcinoma. Urol Oncol 2004;22:214-23.

22. Thompson R, Cheville J, et al. Reclassification of patients with pT3 and pT4 renal cell carcinoma improves prognostic accuracy. Cancer 2005;104:53-60.