Histological subtyping and nuclear grading of renal cell carcinoma and their implications for survival: a retrospective nation-wide study of 629 patients
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Einarsson, Gudmundur V
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CitationEur. Urol. 2005, 48(4):593-600
AbstractOBJECTS: The aim of this study was to evaluate the prognostic significance of the current WHO histological subtyping and Fuhrman nuclear grading on the survival of patients with renal cell carcinoma (RCC). MATERIALS AND METHODS: A retrospective population-based study was carried out on all patients with a histopathologically confirmed diagnosis of RCC in Iceland between 1971 and 2000. Fuhrman grade, TNM stage, and survival were evaluated and multivariate analysis applied in order to determine prognostic factors. RESULTS: Out of 629 patients (387 males, 242 females, mean age 64 years), 558 (88.7%) had clear cell, 53 (8.4%) papillary, and 13 (2.1%) chromophobe RCC. Patient demographics were comparable for the two major subtypes, but chromophobe RCCs were larger in size and were diagnosed at a younger age. Clear cell RCCs were more often of higher grades (G3+G4, 48.4%) and at advanced TNM stages (III+IV, 59.3%) than papillary RCCs (22.6% and 34% respectively, p<0.001). Linear regression analysis showed a strong correlation between grade, tumor size, and stage (p<0.001). Chromophobe RCCs had a better survival in univariate analysis than both papillary and clear cell RCCs (84.6% vs. 66.5% and 54.9% 5-year disease specific survival, p<0.001). However, in the multivariate analysis, only the patient's age, calendar year of diagnosis, TNM stage, and nuclear grade were independent prognostic factors of survival. CONCLUSION: In this complete nation-wide series nuclear grading is important in predicting survival of patients with RCC. It is strongly related to both tumor size and stage, with stage being by far the strongest prognostic factor. Different histological subtypes confer different survival. However, in spite of the distinctive cytogenetic and molecular characteristics of the subtypes, the survival difference is to a large extent due to differences in grade and particularly stage.
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- Papillary (chromophil) renal cell carcinoma: histomorphologic characteristics and evaluation of conventional pathologic prognostic parameters in 62 cases.
- Authors: Amin MB, Corless CL, Renshaw AA, Tickoo SK, Kubus J, Schultz DS
- Issue date: 1997 Jun
- Prognostic indicators for renal cell carcinoma: a multivariate analysis of 643 patients using the revised 1997 TNM staging criteria.
- Authors: Tsui KH, Shvarts O, Smith RB, Figlin RA, deKernion JB, Belldegrun A
- Issue date: 2000 Apr
- Renal cell carcinoma in South Korea: a multicenter study.
- Authors: Kim H, Cho NH, Kim DS, Kwon YM, Kim EK, Rha SH, Park YW, Shim JW, Lee SS, Lee SN, Lee J, Lee JS, Lee TJ, Jung SJ, Jung SH, Chung JH, Cho HY, Joo HJ, Choi YJ, Choi C, Han WS, Hur B, Ro JY, Genitourinary Pathology Study Group of the Korean Society of Pathologists.
- Issue date: 2004 Dec
- Prognostic features of pathologic stage T1 renal cell carcinoma after radical nephrectomy.
- Authors: Lau WK, Cheville JC, Blute ML, Weaver AL, Zincke H
- Issue date: 2002 Apr
- Cyst-associated renal cell carcinoma: clinicopathologic characteristics and evaluation of prognosis in 27 cases.
- Authors: Onishi T, Oishi Y, Goto H, Tomita M, Abe K, Sugaya S
- Issue date: 2001 Jun