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• W2016336310 abstract "No AccessJournal of UrologyAdult Urology1 Aug 2015Pathological Stage T3a Significantly Increases Disease Recurrence across All Tumor Sizes in Renal Cell Carcinoma Michael Chevinsky, Mariam Imnadze, Alexander Sankin, Andrew Winer, Roy Mano, Christopher Jakubowski, Joseph Mashni, Daniel D. Sjoberg, Ying-Bei Chen, Satish K. Tickoo, Victor E. Reuter, A. Ari Hakimi, and Paul Russo Michael ChevinskyMichael Chevinsky Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , Mariam ImnadzeMariam Imnadze Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , Alexander SankinAlexander Sankin Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , Andrew WinerAndrew Winer Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , Roy ManoRoy Mano Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , Christopher JakubowskiChristopher Jakubowski Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , Joseph MashniJoseph Mashni Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , Daniel D. SjobergDaniel D. Sjoberg Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , Ying-Bei ChenYing-Bei Chen Surgical Pathology Diagnostic Service, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , Satish K. TickooSatish K. Tickoo Surgical Pathology Diagnostic Service, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , Victor E. ReuterVictor E. Reuter Surgical Pathology Diagnostic Service, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , A. Ari HakimiA. Ari Hakimi Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , and Paul RussoPaul Russo Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.013AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Tumor size and stage are important prognostic parameters in renal cell carcinoma. While pathological stage T1 and T2 are defined by size alone, the presence of certain intrinsic features can up stage a tumor to pathological stage T3a regardless of size. We investigate the effect of pathological tumor stage on the relationship between tumor size and risk of disease recurrence. Materials and Methods: Data were reviewed on patients who underwent nephrectomy at our institution between 2006 and 2013 to identify all those with pathological stage T1, T2 and T3a tumors. A proportional hazards Cox model was built with time to recurrence as outcome, and pathological stage and tumor size as covariates. An interaction term for stage and tumor size was included. Results: The final cohort included 1,809 patients. On multivariable analysis, when adjusted for tumor size, patients with pT3a tumors had a greater risk of tumor recurrence compared to those with pT1/T2 tumors (HR 3.70; 95% CI 2.31, 5.92; p <0.0001). The risk of disease recurrence increased more rapidly as tumor size increased only with the presence of perinephric fat invasion (p=0.006). Conclusions: Using the AJCC 2010 staging criteria we validated pathological stage T3a as a poor prognostic factor in renal cell carcinoma regardless of tumor size. Our results also demonstrated an increased rate of risk of recurrence with perinephric fat invasion. Given this increased risk of recurrence, even in tumors less than 4 cm, closer surveillance is warranted in such cases and the role of perinephric involvement necessitates further investigation. References 1 : SEER Cancer Statistics Review, 1975-2010. Based on November 2012 SEER data submission, posted to the SEER web site, April 2013. Bethesda: National Cancer Institute2013. Google Scholar 2 : AJCC Cancer Staging Manual. New York: Springer2010. Google Scholar 3 : Accuracy of the revised 2010 TNM classification in predicting the prognosis of patients treated for renal cell cancer in the north east of England. J Clin Pathol2012; 65: 367. Google Scholar 4 : Should direct ipsilateral adrenal invasion from renal cell carcinoma be classified as pT3a?. J Urol2005; 173: 918. Link, Google Scholar 5 : Prognostic impact of muscular venous branch invasion in localized renal cell carcinoma cases. 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Google Scholar © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byShah P, Moreira D, Patel V, Gaunay G, George A, Alom M, Kozel Z, Yaskiv O, Hall S, Schwartz M, Vira M, Richstone L and Kavoussi L (2018) Partial Nephrectomy is Associated with Higher Risk of Relapse Compared with Radical Nephrectomy for Clinical Stage T1 Renal Cell Carcinoma Pathologically Up Staged to T3aJournal of Urology, VOL. 198, NO. 2, (289-296), Online publication date: 1-Aug-2017.Smith J (2018) This Month in Adult UrologyJournal of Urology, VOL. 194, NO. 2, (273-274), Online publication date: 1-Aug-2015. Volume 194Issue 2August 2015Page: 310-315 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.Keywordsrenal cellcarcinomaneoplasm stagingrecurrenceMetricsAuthor Information Michael Chevinsky Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Mariam Imnadze Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Alexander Sankin Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Andrew Winer Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Roy Mano Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Christopher Jakubowski Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Joseph Mashni Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Daniel D. Sjoberg Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Ying-Bei Chen Surgical Pathology Diagnostic Service, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Satish K. Tickoo Surgical Pathology Diagnostic Service, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Victor E. Reuter Surgical Pathology Diagnostic Service, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author A. Ari Hakimi Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Paul Russo Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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