Evaluation of Pathological Prognostic Parameters in Renal Cell Carcinomas: A Single Center Experience

Abstract

Aim: Kidney cancers are the most common cancers in the world. Incidence and mortality rates are increasing in many countries, although they differ according to their socio-economic development status. This study, it was aimed to evaluate the pathological prognostic parameters of renal cell carcinomas (RCC) in the light of literature information. Material and Methods: A total of 105 cases diagnosed with RCC were included in the study. Patients' age, gender, type of surgery (total/subtotal resection), pathological diagnosis, tumor localization, macroscopic tumor appearance, tumor margins (regular/irregular), tumor grade, tumor growth pattern, tumor diameter, renal capsule invasion, perirenal lipomatous tissue invasion, renal vein invasion, presence of tumor necrosis and cystic degeneration, pathological tumor stage, ureter surgical margin, adrenal gland involvement, and metastatic tumor status data were obtained from patient files and pathology reports. Prognostic parameters were reviewed. Results: 71 of the cases were male and 34 of them were female. The age range was between 26 and 87. The most common subtype was clear cell (n=80), followed by papillary type 1 (n=12), chromophobe (n=8) and papillary type 2 (n=5) RCCs. The tumor diameter was between 1.7 cm and 17 cm. The nuclear grade was observed as 2 in 71,1% of the cases. Renal capsule invasion was present in 27 cases, and perirenal adipose tissue invasion was seen in 19 cases. Conclusion: RCCs are a spectrum of diseases with different histological subtypes, with distinctive genetic and molecular changes, and with different responses to therapies due to different clinical behaviors. Prognostic parameters play an important role in establishing individualized surveillance protocols, patient counseling, and determining potential future adjuvant therapy.

Keywords

• renal cell carcinoma
• clear cell
• chromophobe
• papillary type 1
• papillary type 2

Renal Hücreli Karsinomlarda Patolojik Prognostik Parametrelerin Değerlendirilmesi: Tek Merkez Deneyimi

Abstract

Amaç: Böbrek kanserleri dünyada en sık görülen kanserler arasındadır. Sosyoekonomik gelişme durumlarına göre farklılıklar göstermekle birlikte pek çok ülkede insidans ve mortalite oranları artmaktadır. Bu çalışmada renal hücreli karsinomların (RHK) patolojik prognostik parametrelerini literatür bilgileri eşliğinde değerlendirmek amaçlanmıştır. Gereç ve Yöntemler: RHK tanısı alan toplam 105 olgu çalışmaya dahil edildi. Hastalara ait yaş, cinsiyet, ameliyat tipi (parsiyel/total rezeksiyon), patolojik tanı, tümör lokalizasyonu, makroskopik tümör görünümü, tümör sınırları (düzenli/düzensiz), tümör derecesi, tümör büyüme paterni, tümör çapı, renal kapsül invazyonu, perirenal yağ dokusu invazyonu, renal ven invazyonu, tümörde nekroz ve kistik dejenerasyon varlığı, patolojik tümör evresi, üreter cerrahi sınır, adrenal bez tutulumu ve metastatik tümör durumu verileri hasta dosyalarından ve patoloji raporlarından retrospektif olarak elde edildi. Prognostik parametreler gözden geçirildi. Bulgular: Olguların 71’i erkek, 34’ü kadındı. Yaş aralığı 26 ile 87 arasındaydı. En sık görülen alt tip berrak hücreli olup (n=80), onu papiller tip 1 (n=12), kromofob (n=8) ve papiller tip 2 (n=5) RHK’lar takip ediyordu. Tümör çapı 1,7 cm ile 17 cm arasındaydı. Olguların %71,1’inin nükleer derecesi 2 olarak izlendi. 27 olguda renal kapsül invazyonu mevcut olup, perirenal yağ doku invazyonu 19 olguda görüldü. Sonuç: RHK’lar farklı histolojik alt tiplere sahip, ayırt edici genetik ve moleküler değişiklikler içeren, farklı klinik davranışları nedeniyle terapilere farklı yanıtlar veren hastalıkların bir spektrumudur. Bireyselleştirilmiş surveyans protokolleri oluşturmada, hasta danışmasında ve gelecekteki potansiyel adjuvan tedaviyi belirlemede prognostik parametreler önemli role sahiptir.

Keywords

• renal hücreli karsinoma
• berrak hücreli
• kromofob
• papiller tip 1
• papiller tip 2

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