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Background:  To investigate the prognostic role of tumor size in patients with pathological T2N0M0 and T3aN0M0 renal cell carcinoma (RCC) treated by radical surgery.   Methods:  A total of 3,662 cases were retrospectively analyzed from the Surveillance, Epidemiology and End Results (SEER) from 2010 to 2012. Overall survival (OS) and cancer-specific survival (CSS) data were obtained. The log-rank test was used to compare survival distributions and Cox proportional hazards model was used for univariate and multivariate analyses, respectively.   Results:  In the low-risk T3aN0M0 (perinephric fatty infiltration or sinus fatty infiltration only) group, patients with tumor size ≤ 7 cm were associated with a better OS ( P  = 0.009) and CSS ( P  < 0.001) than those with tumor size >7 cm. However, there was no difference in OS ( P  = 0.129) and CSS ( P  = 0.539) between T2bN0M0 patients and low-risk T3aN0M0 patients with tumor size ≤ 7 cm. A new T classification grouping patients with both T2bN0M0 and T3aN0M0 with tumor diameter ≤ 7 cm into the same staging category (pT2aN0M0, pT2bN0M0+low-risk pT3aN0M0 [tumor diameter ≤ 7cm], low-risk pT3aN0M0 [tumor diameter >7 cm], high-risk pT3aN0M0) was proposed and it was found as an independent predictive variable for OS and CSS.   Conclusions:  Findings from the present study suggest that the reclassification of pT2N0M0 and pT3aN0M0 RCC can lead to better prediction of OS and CSS.

Comparison of T2N0M0 and T3aN0M0 in Predicting the Prognosis of Patients With Renal Cell Carcinoma