Prognostic relevance of capsular involvement and collecting system invasion in stage I and II renal cell carcinoma

OBJECTIVE To define the prognostic relevance of capsular involvement (invasion with no penetration) and collecting‐system invasion in patients with stage I (pT1N0M0) and stage II (pT2N0M0) renal cell carcinoma (RCC), by evaluating the outcome of patients treated with nephrectomy. PATIENTS AND METHOD...

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Bibliographic Details
Published in:BJU international 2007-04, Vol.99 (4), p.821-824
Main Authors: Klatte, Tobias, Chung, JinSoo, Leppert, John T., Lam, John S., Pantuck, Allan J., Figlin, Robert A., Belldegrun, Arie S.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Analysis of Variance
Biological and medical sciences
capsule
Carcinoma, Renal Cell - mortality
Carcinoma, Renal Cell - pathology
Carcinoma, Renal Cell - surgery
collecting system
Female
Humans
kidney cancer
Kidney Neoplasms - mortality
Kidney Neoplasms - pathology
Kidney Neoplasms - surgery
Kidney Tubules, Collecting - pathology
Kidneys
Male
Medical sciences
Middle Aged
Neoplasm Invasiveness
Neoplasm Recurrence, Local
Neoplasm Staging
Nephrectomy - standards
Nephrology. Urinary tract diseases
Prognosis
Retrospective Studies
Survival Analysis
Tumors of the urinary system
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Summary:OBJECTIVE To define the prognostic relevance of capsular involvement (invasion with no penetration) and collecting‐system invasion in patients with stage I (pT1N0M0) and stage II (pT2N0M0) renal cell carcinoma (RCC), by evaluating the outcome of patients treated with nephrectomy. PATIENTS AND METHODS In all, 519 patients from a kidney cancer database treated with nephrectomy for stage I and II RCC between 1985 and 2005 were assessed retrospectively. The primary endpoint was recurrence‐free survival time. The prognostic relevance of capsular involvement and collecting‐system invasion were examined using univariate and multivariate survival analysis. RESULTS Capsular involvement and collecting‐system invasion were evident in 112 (21.6%) and 39 (7.5%) patients, respectively. Capsular involvement was associated with higher Fuhrman grades and larger tumours. The incidence of collecting‐system invasion was higher in patients with microvascular invasion. The median follow‐up was 49 months. In univariate analysis, patients with capsular involvement and collecting‐system invasion had a worse prognosis than patients without (P = 0.007 and
ISSN:1464-4096
1464-410X
DOI:10.1111/j.1464-410X.2006.06729.x