Impact of tumor size on patient survival after radical nephrectomy for pathological T3a renal cell carcinoma.

Abstract

PURPOSE:

We recently reported the results from a multi-institutional retrospective outcome study involving 814 patients with renal cell carcinomas (RCCs) who had undergone radical surgery and whose diagnoses were confirmed via a central pathological review. This study aimed to clarify the impact of tumor size on survival outcomes in patients with pT3aN0M0 RCC after radical nephrectomy using this cohort.

METHODS:

Using the Kaplan-Meier method, overall survival (OS), cancer-specific survival (CSS) and relapse-free survival (RFS) were estimated for 103 pT3aN0M0 patients. The differences in the OS, CSS and RFS according to tumor size were evaluated using the log-rank test. To identify independent prognostic factors that affected each survival outcome, clinicopathological factors were examined using univariate and multivariate analyses, and the Cox proportional hazards model.

RESULTS:

The OS, CSS and RFS rates for 26 patients with pT3a RCCs ≤4 cm were significantly better than those for 77 patients with pT3a RCCs that were 4-7 cm or >7 cm (P = 0.0064, 0.0169 and 0.0001, respectively). Tumor size and venous invasion were independent prognosticators for OS, CSS and RFS. The OS and CSS for patients with pT3a tumors ≤4 cm were comparable with those for patients with pT1 RCCs, and the RFS for patients with pT3a RCCs ≤4 cm was similar to that for patients with pT1b RCCs.

CONCLUSIONS:

Tumor size significantly influenced the prognosis for patients with pT3aN0M0 RCC. This study's results suggest that the postoperative management of pT3a RCCs could be individualized according to tumor size.

• Authors: Yutaka Sugiyama, Junji Yatsuda, Yoji Murakami, Noriyuki Ito, Toshinari Yamasaki, Yoshiki Mikami, Osamu Ogawa, Tomomi Kamba
• Journal: Japanese journal of clinical oncology (Jpn J Clin Oncol) Vol. 49 Issue 5 Pg. 465-472 (May 01 2019) ISSN: 1465-3621 [Electronic] England
• PMID: 30793163 (Publication Type: Journal Article)
• Copyright: © The Author(s) 2019. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: [email protected].

Topics

• Aged
• Carcinoma, Renal Cell (pathology, surgery)
• Cohort Studies
• Female
• Humans
• Kaplan-Meier Estimate
• Kidney Neoplasms (pathology, surgery)
• Male
• Middle Aged
• Multivariate Analysis
• Neoplasm Recurrence, Local (surgery)
• Neoplasm Staging
• Nephrectomy
• Prognosis
• Proportional Hazards Models
• Retrospective Studies
• Tumor Burden