Clinical Significance of Tumor Size, Pathological Invasion Sites Including Urinary Collecting System and Clinically Detected Renal Vein Thrombus as Predictors for Recurrence in pT3a Localized Renal Cell Carcinoma
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients Selection
2.2. Ethical Approval
2.3. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Exploration of Prognostic Factors for RFS and CSS
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variables | Number of Patients | % | |
---|---|---|---|
(n = 91) | 100 | ||
Gender | Male Female | 65 26 | 71.4 28.6 |
Age | Median (Range) | 68 (41–87) | |
Follow-up (month) | Median (Range) | 48 (6–134) | |
Charlson comorbidity index | 0 ≥1 | 41 50 | 45.1 54.9 |
CRP | <0.5 ≥0.5 | 61 30 | 67.0 33.0 |
Clinical T stage | cT1a/1b cT2a/2b cT3a/3b/3c cT4 | 14/21 7/9 32/6/0 2 | 15.4/23.1 7.7/9.9 35.2/6.6/0 2.2 |
Clinically detected renal vein thrombus | − + | 74 17 | 81.3 18.7 |
Type of Surgery | RN PN | 84 7 | 92.3 7.7 |
Tumor size (cm) | Median (Range) | 6.4 (1.4–14) | |
≤7 >7 | 62 29 | 68.1 31.9 | |
Histological type | Clear cell Papillary Chromophobe others | 74 11 3 3 | 81.3 12.1 3.3 3.3 |
Fuhrman Grade | 1–2 3–4 NA | 39 39 13 | 42.9 42.9 14.2 |
INF | a b c | 16 73 2 | 17.6 82.4 2.2 |
LVI | − + | 29 61 | 31.9 67.0 |
Urinary collecting system invasion | − + | 69 22 | 75.8 24.2 |
Pathologically invasion subgroups | |||
Renal vein invasion | − + | 45 46 | 49.5 50.5 |
Peri renal fat invasion | − + | 57 34 | 62.6 37.4 |
Renal sinus fat invasion | − + | 36 55 | 39.6 60.4 |
Pathologically invasion number of subgroups | 1 2 3 | 56 26 9 | 61.5 28.6 9.9 |
Variables | Univariate Analysis | Multivariate Analysis | |||||
---|---|---|---|---|---|---|---|
HR | 95% CI | p Value | HR | 95% CI | p Value | ||
Gender | Male | 1 | 0.37 | ||||
Female | 1.48 | 0.61–3.57 | |||||
Age | ≥70 | 1 | 0.26 | ||||
<70 | 1.55 | 0.72–3.37 | |||||
CRP | <0.5 | 1 | 0.009 * | not included | |||
≥0.5 | 3.05 | 1.32–7.06 | |||||
clinically detected renal vein thrombus | − | 1 | 0.0074 * | 1 | <0.001 * | ||
+ | 4.07 | 1.45–11.37 | 4.10 | 1.86–9.01 | |||
Fuhrman Grade | G1,2 | 1 | 0.015 * | not included | |||
G3,4 | 2.97 | 1.23–7.17 | |||||
INF | a | 1 | 0.011 * | not included | |||
b/c | 3.53 | 1.33–9.38 | |||||
LVI | − | 1 | 0.03 * | not included | |||
+ | 2.39 | 1.06–5.37 | |||||
Necrosis | − | 1 | 0.0003 * | not included | |||
+ | 4.26 | 1.96–9.28 | |||||
Histological classification | non-ccRCC | 1 | 0.44 | ||||
ccRCC | 0.64 | 0.21–1.97 | |||||
Sarcomatoid variant | − | 1 | 0.94 | ||||
+ | 1.08 | 0.13–8.77 | |||||
Tumor size | ≤7 | 1 | 0.013 * | 1 | 0.004 * | ||
>7 | 2.98 | 1.26–7.05 | 3.27 | 1.46–7.31 | |||
Urinary collecting system invasion | − | 1 | <0.0001 * | 1 | 0.001 * | ||
+ | 8.86 | 3.10–25.34 | 4.26 | 1.86–9.76 | |||
Pathologically renal vein invasion | − | 1 | 0.022 * | not included | |||
+ | 2.42 | 1.13–5.21 | |||||
Pathologically peri renal fat invasion | − | 1 | 0.21 | ||||
+ | 1.67 | 0.74–3.73 | |||||
Pathologically renal sinus fat invasion | − | 1 | 0.22 | ||||
+ | 0.612 | 0.27–1.34 | |||||
Pathologically invasion numbers of subgroups | 1/2 | 1 | 0.0008 * | not included | |||
3 | 14.28 | 3.03–67.1 |
Variables | Univariate Analysis | |||
---|---|---|---|---|
HR | 95% CI | p Value | ||
Gender | Male | 1 | 0.25 | |
Female | 2.29 | 0.54–9.75 | ||
Age | ≥70 | 1 | 0.81 | |
<70 | 1.17 | 0.33–4.08 | ||
CRP | <0.5 | 1 | 0.28 | |
≥0.5 | 2.01 | 0.55–7.64 | ||
clinically renal vein thrombus | − | 1 | 0.049 * | |
+ | 5.08 | 0.98–26.44 | ||
Fuhrman Grade | G1,2 | 1 | 0.07 | |
G3,4 | 4.49 | 0.85–23.72 | ||
INF | a | 1 | 0.15 | |
b/c | 3.38 | 0.66–17.42 | ||
LVI | − | 1 | 0.14 | |
+ | 2.72 | 0.71–10.33 | ||
Necrosis | − | 1 | 0.48 | |
+ | 1.56 | 0.45–5.42 | ||
Histological classification | non-ccRCC | 1 | 0.30 | |
ccRCC | 0.42 | 0.10–2.15 | ||
Sarcomatoid variant | − | 1 | 0.5 | |
+ | 0.34 | 0.01–7.56 | ||
tumor size | ≤7 | 1 | 0.07 | |
>7 | 3.25 | 0.87–12.11 | ||
Urinary collecting system invasion | − | 1 | 0.07 | |
+ | 4.35 | 0.86–22.01 | ||
Pathologically renal vein invasion | − | 1 | 0.4 | |
+ | 1.69 | 0.48–5.86 | ||
Pathologically peri renal fat invasion | − | 1 | 0.21 | |
+ | 9.1 | 2.42–34. | ||
Pathologically renal sinus fat invasion | − | 1 | 0.27 | |
+ | 1.41 | 0.39–5.06 | ||
Pathologically invasion of subgroups | 1/2 | 1 | <0.0001 * | |
3 | NA | 91–13,500 |
Spearman r | p Value | |
---|---|---|
Hematuria | 0.54 | <0.0001 |
Micro Hematuria | 0.43 | <0.0001 |
Macro Hematuria | 0.41 | <0.0001 |
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Shimizu, T.; Miyake, M.; Hori, S.; Iida, K.; Ichikawa, K.; Sakamoto, K.; Miyamoto, T.; Nakai, Y.; Inoue, T.; Anai, S.; et al. Clinical Significance of Tumor Size, Pathological Invasion Sites Including Urinary Collecting System and Clinically Detected Renal Vein Thrombus as Predictors for Recurrence in pT3a Localized Renal Cell Carcinoma. Diagnostics 2020, 10, 154. https://doi.org/10.3390/diagnostics10030154
Shimizu T, Miyake M, Hori S, Iida K, Ichikawa K, Sakamoto K, Miyamoto T, Nakai Y, Inoue T, Anai S, et al. Clinical Significance of Tumor Size, Pathological Invasion Sites Including Urinary Collecting System and Clinically Detected Renal Vein Thrombus as Predictors for Recurrence in pT3a Localized Renal Cell Carcinoma. Diagnostics. 2020; 10(3):154. https://doi.org/10.3390/diagnostics10030154
Chicago/Turabian StyleShimizu, Takuto, Makito Miyake, Shunta Hori, Kota Iida, Kazuki Ichikawa, Keiichi Sakamoto, Tatsuki Miyamoto, Yasushi Nakai, Takeshi Inoue, Satoshi Anai, and et al. 2020. "Clinical Significance of Tumor Size, Pathological Invasion Sites Including Urinary Collecting System and Clinically Detected Renal Vein Thrombus as Predictors for Recurrence in pT3a Localized Renal Cell Carcinoma" Diagnostics 10, no. 3: 154. https://doi.org/10.3390/diagnostics10030154