Small renal cell carcinomas--how dangerous are they really? Results of a large multicenter study

Steffens S, Junker K, Roos FC, Janssen M, Becker F, Henn D, Wegener G, Siemer S, Hofmann R, Schrader M, Stoeckle M, Thueroff JW, Hartmann A, Kuczyk MA, Schrader AJ (2014)

Publication Type: Journal article

Publication year: 2014

Journal

European Journal of Cancer Elsevier

Book Volume: 50

Pages Range: 739-45

Journal Issue: 4

DOI: 10.1016/j.ejca.2013.11.020

Abstract

Modern diagnostic ultrasound and cross-sectional imaging has enabled the detection of increasing numbers of renal tumours. The aim of this study was to investigate the tumour- and patient-specific characteristics and prognosis of small renal cell carcinomas (RCCs) after surgical resection.The study included 2197 patients who underwent surgical resection of histologically confirmed RCC ? 4 cm between 1990 and 2011. Median (mean) follow-up was 56.2 (65.5) months.At the time of surgery, tumours were staged as pT ? 3a in 175 (8.0%) cases, 134 (6.2%) were poorly differentiated and 75 (3.5%) were metastasised. The larger the tumour size, the higher was the risk of presenting with stage pT ? 3a (p<0.001), poor tumour differentiation (p = 0.004), microscopic vascular involvement (p = 0.001) and collecting system invasion (p = 0.03). The 5-year cancer-specific survival (CSS) rate was 93.8% for stage pT1a versus 79.4% for stage pT ? 3a (p<0.001), and it was 93.7% for G1-2 versus 76.8% for G3-4 differentiation (p<0.001). Multivariate analysis identified age in years (hazard ratio (HR) 1.04, p<0.001), metastatic disease (HR 12.5, p < 0.001), tumour differentiation (HR 2.8, p<0.001) and non-clear cell histology (HR 0.51, p = 0.02) as independent prognosticators for CSS in patients with small RCC. Interestingly, the 5-year cancer-specific mortality rate for pT1a N/M0 patients was 5.8%.This large multicenter study has clearly shown that, though most small RCC have a low pathological stage and a good prognosis, there is also a small but significant subgroup of these tumours that are already locally advanced or poorly differentiated.

Authors with CRIS profile

Arndt Hartmann Lehrstuhl für Allgemeine Pathologie und Pathologische Anatomie

Involved external institutions

Gottfried Wilhelm Leibniz Universität Hannover DE Germany (DE) Universität des Saarlandes (UdS) DE Germany (DE) Johannes Gutenberg-Universität Mainz (JGU) DE Germany (DE) Universität Ulm DE Germany (DE) Philipps-Universität Marburg DE Germany (DE)

How to cite

APA:

Steffens, S., Junker, K., Roos, F.C., Janssen, M., Becker, F., Henn, D.,... Schrader, A.J. (2014). Small renal cell carcinomas--how dangerous are they really? Results of a large multicenter study. European Journal of Cancer, 50(4), 739-45. https://doi.org/10.1016/j.ejca.2013.11.020

MLA:

Steffens, Sandra, et al. "Small renal cell carcinomas--how dangerous are they really? Results of a large multicenter study." European Journal of Cancer 50.4 (2014): 739-45.

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