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10 cm'den büyük böbrek hücreli kanserli hastaların klinik ve histopatolojik özellikleri

Year 2022, Volume: 3 Issue: 2, 44 - 47, 25.08.2022
https://doi.org/10.29228/anatoljhr.58174

Abstract

Amaç: Bu çalışmada >10 cm böbrek kanseri (BK) olan hastaların klinik ve histopatolojik özelliklerini değerlendirmeyi amaçladık.
Yöntem: BK nedeniyle radikal/parsiyel nefrektomi yapılan hastaların verileri geriye dönük olarak değerlendirildi. Hastalar tümör boyutlarına göre (≤10 cm ve >10 cm) iki gruba ayrıldı. Demografik özellikler, histolojik tümör alt tipi, tümör derecesi, nefrektomi sonrası sağkalım ve metastaz verileri kaydedildi.
Bulgular: 116 hastanın verileri analiz edildi. Hastaların ortalama yaşı 57.6 idi. Ortalama tümör boyutu ameliyat öncesi tomografide 50 mm (dağılım: 15-150) mm ve patoloji örneğinde 50 mm (dağılım: 10-140) idi. Ortalama takip süresi 24.59±12.95 aydı. Çalışmaya dahil edilen 116 hastanın tümör boyutu 15 hastada >10 cm (grup 1), 101 hastada ≤10 cm (grup 2) idi. Grup 1'deki tüm hastalara radikal nefrektomi yapıldı. Grup 2'de 49 hastaya (%48.5) parsiyel nefrektomi ve 52 hastaya (%51.5) radikal nefrektomi uygulandı. Daha yüksek evre ve daha yüksek derece insidansı grup 1'de grup 2'ye göre anlamlı derecede yüksekti (p<0.05). Grup 1'de 3 (%20) hastada ve grup 2'de 5 (%4.9) hastada uzak metastaz mevcuttu (p<0.05). Kansere özgü sağkalım (KÖS), grup 2'de grup 1'e göre anlamlı olarak daha yüksekti (%96.1'e karşı %86.6, p<0.05).
Sonuçlar: >10 cm BK olan hastalarda metastaz oranı daha yüksek ve KÖS daha düşüktür. Bu hastalar metastaz açısından daha dikkatli takip edilmelidir.

References

  • Cheville, J. C., Blute, M. L., Zincke, H., Lohse, C. M., & Weaver, A. L. (2001). Stage pT1 conventional (clear cell) renal cell carcinmoa: pathological features associated with cancer specific survival. Journal of Urology, 166(2), 453-456.
  • Delahunt, B., Bethwaite, P. B., & Nacey, J. N. (2007). Outcome prediction for renal cell carcinoma: evaluation of prognostic factors for tumours divided according to histological subtype. Pathology, 39, 459-465.
  • Dorin, R., Jackson, M., Cusano, A., Haddock, P., Kiziloz, H., Meraney, A., & Shichman, S. (2014). Active surveillance of renal masses: an analysis of growth kinetics and clinical outcomes stratified by radiological characteristics at diagnosis. International Brazilian Journal of Urology, 40(5), 627-636.
  • Frank, I., Blute, M. L., Cheville, J. C., Lohse, C. M., Weaver, A. L., Leibovich, B. C., & Zincke, H. (2003). A multifactorial postoperative surveillance model for patients with surgically treated clear cell renal cell carcinoma. Journal of Urology, 170, 2225-2232.
  • Frank, I., Blute, M. L., Leibovich, B. C., Cheville, J. C., Lohse, C. M., Kwon, E. D., & Zincke, H. (2005). pT2 classification for renal cell carcinoma. Can its accuracy be improved? Journal of Urology, 173(2), 380-384.
  • Hamidi, N., Süer, E., Gökçe, I., Bedük, Y., & Baltacı, S. (2017). The effect of tumor size on oncologic outcomes in pathological T2 stage renal cell carcinoma patients. Bulletin of Urooncology, 16, 1-3.
  • Karakiewicz, P. I., Briganti, A., Chun, F. K., Trinh, Q. D., Perrotte, P., Ficarra, V.,… & Patard, J. J. (2007). Multi-institutional validation of a new renal cancer-specific survival nomogram. Journal of Clinical Oncology, 25(11), 1316-1322.
  • Lee, S. E., Lee, W. K., Kim, D. S., Doo, S. H., Park, H. Z., Yoon, C. Y.,… & Hong, S. K. (2010). Comparison of radiographic and pathologic sizes of renal tumours. World Journal of Urology, 28(3), 263-267.
  • Leibovich, B. C., Lohse, C. M., Crispen, P. L., Boorjian, S. A., Thompson, R. H., Blute, M. L., & Cheville, J. C. (2010). Histological subtype is an independent predictor of outcome for patients with renal cell carcinoma. Journal of Urology, 183(4), 1309-1315.
  • Ljungberg, B., Albiges, L., Bedke, J., Bex, A., Capitanio, U., Giles, R. H.,… & Tahbaz, R. (2021). EAU guideline on renal cell carcinoma. European Association of Urology, http://uroweb.org/guideline/renal-cell-carcinoma
  • Mason, R. J., Abdolell, M., Trottier, G., Pringle, C., Lawen, J. G., Bell, D. G.,… & Rendon, R. A. (2011). Growth kinetics of renal masses: analysis of a prospective cohort of patients undergoing active surveillance. European Urology, 59(5), 863-867.
  • Moch, H., Cubilla, A. L., Humphrey, P. A., Reuter, V. E., & Ulbright, T. M. (2016). The 2016 WHO classification of tumours of the urinary system and male genital organs-part A: Renal, penile, and testicular tumours. European Urology, 70(1), 93-105.
  • Patard, J. J., Leray, E., Rioux-Leclercq, N., Cindolo, L., Ficarra, V., Zisman, A.,… & Pantuck, A. J. (2005). Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience. Journal of Clinical Oncology, 23(12), 2763-2771.
  • Sun M, Lughezzani, G., Jeldres, C., Isbarn, H., Shariat, S.F., Arjane, P.,… & Karakiewicz, P. I. (2009). A proposal for reclassification of the Fuhrman grading system in patients with clear cell renal cell carcinoma. European Urology, 56(5), 775-781.
  • Sun, M., Shariat, S. F., & Karakiewicz, P. I. (2010). Factors affecting outcome in renal cell carcinoma. Current Opinion in Urology, 20(5), 355-360.
  • Yaycioglu, O., Rutman, M. P., Balasubramaniam, M., Peters, K. M., & Gonzalez, J. A. (2002). Clinical and pathologic tumour size in renal cell carcinoma; difference, correlation, and analysis of the influencing factors. Urology, 60(1), 33-38.
  • Waalkes, S., Becker, F., Schrader, A. J., Janssen, M., Wegener, G., Merseburger, A. S., … & Kuczyk, M. A. (2011). Is there a need to further subclassify pT2 renal cell cancers as implemented by the revised 7th TNM version? European Urology, 59(2), 258-263.

Clinical and histopathological characteristics of patients with renal cell cancer larger than 10 cm

Year 2022, Volume: 3 Issue: 2, 44 - 47, 25.08.2022
https://doi.org/10.29228/anatoljhr.58174

Abstract

Aim: In this study, we aimed to evaluate the clinical and histopathological characteristics of patients with renal cell cancer (RCC) > 10 cm.
Methods: Data of patients who underwent radical/partial nephrectomy due RCC were retrospectively evaluated. Patients were divided into two groups according to their tumor sizes (≤10 cm and >10 cm). The data of demographics, histological tumor subtype, tumor grade, survival after nephrectomy, and metastasis were recorded.
Results: Data from 116 patients were analysed. Mean age of the patients was 57.6 years. The mean tumour size was 50 (range: 15-150) mm in preoperative tomography, and 50 (range: 10-140) mm in pathology specimen. Mean follow up of time was 24.59±12.95 months. Out of 116 patients included in the study, tumour size were >10 cm in 15 patients (group 1) and ≤10 cm in 101 patients (group 2). Radical nephrectomy was performed to all patients in group 1. In group 2, 49 (48.5%) patients underwent partial nephrectomy and 52 (51.5%) patients underwent radical nephrectomy. The incidence of higher stage and higher grade in group 1 was significantly higher than group 2 (p<0.05). Distant metastasis was present in 3 (20%) patients from group 1 and 5 (4.9%) patients from group 2 (p<0.05). Cancer specific survival (CSS) was significantly higher in group 2 than in group 1 (96.1% vs. 86.6%, p<0.05).
Conclusion: Patients with RCC >10 cm have a higher metastasis rate and lower CSS. These patients should be followed more carefully for metastasis.

References

  • Cheville, J. C., Blute, M. L., Zincke, H., Lohse, C. M., & Weaver, A. L. (2001). Stage pT1 conventional (clear cell) renal cell carcinmoa: pathological features associated with cancer specific survival. Journal of Urology, 166(2), 453-456.
  • Delahunt, B., Bethwaite, P. B., & Nacey, J. N. (2007). Outcome prediction for renal cell carcinoma: evaluation of prognostic factors for tumours divided according to histological subtype. Pathology, 39, 459-465.
  • Dorin, R., Jackson, M., Cusano, A., Haddock, P., Kiziloz, H., Meraney, A., & Shichman, S. (2014). Active surveillance of renal masses: an analysis of growth kinetics and clinical outcomes stratified by radiological characteristics at diagnosis. International Brazilian Journal of Urology, 40(5), 627-636.
  • Frank, I., Blute, M. L., Cheville, J. C., Lohse, C. M., Weaver, A. L., Leibovich, B. C., & Zincke, H. (2003). A multifactorial postoperative surveillance model for patients with surgically treated clear cell renal cell carcinoma. Journal of Urology, 170, 2225-2232.
  • Frank, I., Blute, M. L., Leibovich, B. C., Cheville, J. C., Lohse, C. M., Kwon, E. D., & Zincke, H. (2005). pT2 classification for renal cell carcinoma. Can its accuracy be improved? Journal of Urology, 173(2), 380-384.
  • Hamidi, N., Süer, E., Gökçe, I., Bedük, Y., & Baltacı, S. (2017). The effect of tumor size on oncologic outcomes in pathological T2 stage renal cell carcinoma patients. Bulletin of Urooncology, 16, 1-3.
  • Karakiewicz, P. I., Briganti, A., Chun, F. K., Trinh, Q. D., Perrotte, P., Ficarra, V.,… & Patard, J. J. (2007). Multi-institutional validation of a new renal cancer-specific survival nomogram. Journal of Clinical Oncology, 25(11), 1316-1322.
  • Lee, S. E., Lee, W. K., Kim, D. S., Doo, S. H., Park, H. Z., Yoon, C. Y.,… & Hong, S. K. (2010). Comparison of radiographic and pathologic sizes of renal tumours. World Journal of Urology, 28(3), 263-267.
  • Leibovich, B. C., Lohse, C. M., Crispen, P. L., Boorjian, S. A., Thompson, R. H., Blute, M. L., & Cheville, J. C. (2010). Histological subtype is an independent predictor of outcome for patients with renal cell carcinoma. Journal of Urology, 183(4), 1309-1315.
  • Ljungberg, B., Albiges, L., Bedke, J., Bex, A., Capitanio, U., Giles, R. H.,… & Tahbaz, R. (2021). EAU guideline on renal cell carcinoma. European Association of Urology, http://uroweb.org/guideline/renal-cell-carcinoma
  • Mason, R. J., Abdolell, M., Trottier, G., Pringle, C., Lawen, J. G., Bell, D. G.,… & Rendon, R. A. (2011). Growth kinetics of renal masses: analysis of a prospective cohort of patients undergoing active surveillance. European Urology, 59(5), 863-867.
  • Moch, H., Cubilla, A. L., Humphrey, P. A., Reuter, V. E., & Ulbright, T. M. (2016). The 2016 WHO classification of tumours of the urinary system and male genital organs-part A: Renal, penile, and testicular tumours. European Urology, 70(1), 93-105.
  • Patard, J. J., Leray, E., Rioux-Leclercq, N., Cindolo, L., Ficarra, V., Zisman, A.,… & Pantuck, A. J. (2005). Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience. Journal of Clinical Oncology, 23(12), 2763-2771.
  • Sun M, Lughezzani, G., Jeldres, C., Isbarn, H., Shariat, S.F., Arjane, P.,… & Karakiewicz, P. I. (2009). A proposal for reclassification of the Fuhrman grading system in patients with clear cell renal cell carcinoma. European Urology, 56(5), 775-781.
  • Sun, M., Shariat, S. F., & Karakiewicz, P. I. (2010). Factors affecting outcome in renal cell carcinoma. Current Opinion in Urology, 20(5), 355-360.
  • Yaycioglu, O., Rutman, M. P., Balasubramaniam, M., Peters, K. M., & Gonzalez, J. A. (2002). Clinical and pathologic tumour size in renal cell carcinoma; difference, correlation, and analysis of the influencing factors. Urology, 60(1), 33-38.
  • Waalkes, S., Becker, F., Schrader, A. J., Janssen, M., Wegener, G., Merseburger, A. S., … & Kuczyk, M. A. (2011). Is there a need to further subclassify pT2 renal cell cancers as implemented by the revised 7th TNM version? European Urology, 59(2), 258-263.
There are 17 citations in total.

Details

Primary Language English
Subjects Public Health (Other)
Journal Section Research Articles
Authors

Adem Emrah Coğuplugil 0000-0002-6240-4989

Selahattin Bedir 0000-0003-4999-9217

Publication Date August 25, 2022
Published in Issue Year 2022 Volume: 3 Issue: 2

Cite

APA Coğuplugil, A. E., & Bedir, S. (2022). Clinical and histopathological characteristics of patients with renal cell cancer larger than 10 cm. Anatolian Journal of Health Research, 3(2), 44-47. https://doi.org/10.29228/anatoljhr.58174

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