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Prognostic significance of tumor grade for renal cell carcinoma
Author(s) -
Onodera Yasutada,
Matsuda Nobuyasu,
Ohta Michiya,
Goto Ryuta,
Fujii Nobukatsu,
Yamada Yasuyo,
Ikeuchi Takao,
Kai Yoshio
Publication year - 2000
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1046/j.1442-2042.2000.00132.x
Subject(s) - medicine , adipose capsule of kidney , renal cell carcinoma , nephrectomy , renal vein , proportional hazards model , stage (stratigraphy) , urology , metastasis , multivariate analysis , clear cell renal cell carcinoma , hazard ratio , population , carcinoma , gastroenterology , kidney , cancer , confidence interval , environmental health , biology , paleontology
Background: The natural history and prognosis of renal cell carcinoma cannot be predicted. Based on the Japanese classification system, the value of nuclear grade were assessed as a possible prognostic factor for renal cell carcinomas.Methods: In this retrospective study of 116 patients with renal cell carcinoma, radical nephrectomy was performed. Survival rates were calculated using the Kaplan–Meier method and multivariate analysis was performed using Cox’s proportional hazard model.Results: Distribution by stage and grade in the population of renal cell carcinomas was as follows: pT1 in 13 cases (11.3%), pT2 in 65 cases (56.5%), pT3 in 36 cases (31.3%) and pT4 in one case (0. 9%) and grade 1, 28 (24.1%), grade 2, 69 (59.5%) and grade 3, 16 (13.8%). Three cases could not be determined because of pre‐operative embolization of the renal cell carcinomas. Nuclear grade was correlated with stage ( P = 0.0002), the presence of perirenal fat involvement ( P = 0.003) and metastases ( P = 0.007). A significant difference in survival was found between grades 1 and 3 ( P = 0.0001) and grades 2 and 3 ( P = 0.0001), respectively. Survival was significantly correlated with sex ( P = 0.0125), tumor size ( P = 0.0001), the presence of lymph node metastasis ( P = 0.0001), renal vein involvement ( P = 0.0001), perirenal fat involvement ( P = 0.002) or distant metastasis ( P = 0.0001). The multivariate analysis showed that the occurrence of tumor grade ( P = 0.0006) or distant metastasis were independent prognostic values.Conclusion: The observations lead us to conclude that the nuclear grade according to the Japanese classification system appears to be of reliable prognostic value for renal cell carcinomas.