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Oncological outcomes of patients with incidental pathological T3a stage small renal cell carcinoma after partial nephrectomy

  • Original Article – Clinical Oncology
  • Published:
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Abstract

Purpose

This study was designed to evaluate and compare the oncological outcomes of patients with pathological T1a (pT1a) small renal cell carcinomas (RCCs) with those with incidental pathological T3a (pT3a) RCCs who have been treated using partial nephrectomy (PN).

Methods

We retrospectively evaluated the records of 1367 consecutive patients who underwent PN for small RCCs (≤4 cm) between 1997 and 2014. The curves for recurrence-free, cancer-specific, and overall survival were estimated using the Kaplan–Meier method. Cox regression analysis was used to estimate the prognostic significance of each variable.

Results

Of the 1367 small RCC patients identified, 1324 (96.8 %) had pT1a lesions and 43 (3.2 %) had pT3a lesions. The median ages of the pT1a and pT3a patients were 53.9 and 58.1 years, respectively. Patients received follow-up for a median of 54 months. The 5- and 10-year RFS rates in patients with pT1a and pT3a RCCs were 98.0 and 95.2 %, and 94.4 and 95.2 %, respectively (P = 0.521). None of the patients with recurrent tumors in the pT3a group have died by the time of the writing of this report. A multivariate Cox proportional hazards model showed that tumor size was a significant predictor of RFS and CSS (P < 0.05). However, pT stage (pT3a vs. pT1a) was not a significant predictor of RFS, CSS, or OS (P = 0.104, P = 0.573, and P = 0.441, respectively).

Conclusions

Our study found that pT3a stage disease following PN for small RCCs (≤4 cm) had similar oncological outcomes to those of pT1a stage.

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References

  • Aboumarzouk OM, Stein RJ, Eyraud R, Haber GP, Chlosta PL, Somani BK, Kaouk JH (2012) Robotic versus laparoscopic partial nephrectomy: a systematic review and meta-analysis. Eur Urol 62:1023–1033

    Article  PubMed  Google Scholar 

  • Bensalah K, Pantuck AJ, Rioux-Leclercq N, Thuret R, Montorsi F, Karakiewicz PI, Mottet N, Zini L, Bertini R, Salomon L, Villers A, Soulie M, Bellec L, Rischmann P, De la Taille A, Avakian R, Crepel M, Ferriere JM, Bernhard JC, Dujardin T, Pouliot F, Rigaud J, Pfister C, Albouy B, Guy L, Joniau S, van Poppel H, Lebret T, Culty T, Saint F, Zisman A, Raz O, Lang H, Spie R, Wille A, Roigas J, Aguilera A, Rambeaud B, Martinez Pineiro L, Nativ O, Farfara R, Richard F, Roupret M, Doehn C, Bastian PJ, Muller SC, Tostain J, Belldegrun AS, Patard JJ (2010) Positive surgical margin appears to have negligible impact on survival of renal cell carcinomas treated by nephron-sparing surgery. Eur Urol 57:466–471

    Article  PubMed  Google Scholar 

  • Breda A, Stepanian SV, Liao J, Lam JS, Guazzoni G, Stifelman M, Perry K, Celia A, Breda G, Fornara P, Jackman S, Rosales A, Palou J, Grasso M, Pansadoro V, Disanto V, Porpiglia F, Milani C, Abbou C, Gaston R, Janetschek G, Soomro NA, de la Rosette J, Laguna MP, Schulam PG (2007) Positive margins in laparoscopic partial nephrectomy in 855 cases: a multi-institutional survey from the United States and Europe. J Urol 178:47–50 (discussion 50)

    Article  CAS  PubMed  Google Scholar 

  • Campbell SC, Novick AC, Belldegrun A, Blute ML, Chow GK, Derweesh IH, Faraday MM, Kaouk JH, Leveillee RJ, Matin SF, Russo P, Uzzo RG (2009) Guideline for management of the clinical T1 renal mass. J Urol 182:1271–1279

    Article  PubMed  Google Scholar 

  • Clark PE, Schover LR, Uzzo RG, Hafez KS, Rybicki LA, Novick AC (2001) Quality of life and psychological adaptation after surgical treatment for localized renal cell carcinoma: impact of the amount of remaining renal tissue. Urology 57:252–256

    Article  CAS  PubMed  Google Scholar 

  • Dash A, Vickers AJ, Schachter LR, Bach AM, Snyder ME, Russo P (2006) Comparison of outcomes in elective partial vs radical nephrectomy for clear cell renal cell carcinoma of 4–7 cm. BJU Int 97:939–945

    Article  PubMed  Google Scholar 

  • Fuhrman SA, Lasky LC, Limas C (1982) Prognostic significance of morphologic parameters in renal cell carcinoma. Am J Surg Pathol 6:655–663

    Article  CAS  PubMed  Google Scholar 

  • Huang WC, Levey AS, Serio AM, Snyder M, Vickers AJ, Raj GV, Scardino PT, Russo P (2006) Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol 7:735–740

    Article  PubMed  PubMed Central  Google Scholar 

  • Huang WC, Elkin EB, Levey AS, Jang TL, Russo P (2009) Partial nephrectomy versus radical nephrectomy in patients with small renal tumors—is there a difference in mortality and cardiovascular outcomes? J Urol 181:55–61 (discussion 61–52)

    Article  PubMed  Google Scholar 

  • Jang HJ, Song W, Suh YS, Jeong US, Jeon HG, Jeong BC, Jeon SS, Lee HM, Choi HY, Seo SI (2014) Comparison of perioperative outcomes of robotic versus laparoscopic partial nephrectomy for complex renal tumors (RENAL nephrometry score of 7 or higher). Korean J Urol 55:808–813

    Article  PubMed  PubMed Central  Google Scholar 

  • Jeldres C, Patard JJ, Capitanio U, Perrotte P, Suardi N, Crepel M, Ficarra V, Cindolo L, de La Taille A, Tostain J, Pfister C, Albouy B, Colombel M, Mejean A, Lang H, Jacqmin D, Bernhard JC, Ferriere JM, Bensalah K, Karakiewicz PI (2009) Partial versus radical nephrectomy in patients with adverse clinical or pathologic characteristics. Urology 73:1300–1305

    Article  PubMed  Google Scholar 

  • Kwon EO, Carver BS, Snyder ME, Russo P (2007) Impact of positive surgical margins in patients undergoing partial nephrectomy for renal cortical tumours. BJU Int 99:286–289

    Article  PubMed  Google Scholar 

  • Lane BR, Campbell SC, Gill IS (2013) 10-year oncologic outcomes after laparoscopic and open partial nephrectomy. J Urol 190:44–49

    Article  PubMed  Google Scholar 

  • Lau WK, Blute ML, Weaver AL, Torres VE, Zincke H (2000) Matched comparison of radical nephrectomy vs nephron-sparing surgery in patients with unilateral renal cell carcinoma and a normal contralateral kidney. Mayo Clin Proc 75:1236–1242

    Article  CAS  PubMed  Google Scholar 

  • Ljungberg B, Bensalah K, Canfield S, Dabestani S, Hofmann F, Hora M, Kuczyk MA, Lam T, Marconi L, Merseburger AS, Mulders P, Powles T, Staehler M, Volpe A, Bex A (2015) EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol 67:913–924

    Article  PubMed  Google Scholar 

  • Louis R, Kavoussi AWP, Novick AC, Peters CA (2012) Campbell-Walsh urology, 10th edn. Elsevier, Philadelphia

    Google Scholar 

  • Mitchell RE, Gilbert SM, Murphy AM, Olsson CA, Benson MC, McKiernan JM (2006) Partial nephrectomy and radical nephrectomy offer similar cancer outcomes in renal cortical tumors 4 cm or larger. Urology 67:260–264

    Article  PubMed  Google Scholar 

  • Oh JJ, Byun SS, Lee SE, Hong SK, Lee ES, Kim HH, Kwak C, Ku JH, Jeong CW, Kim YJ, Kang SH, Hong SH (2014) Partial nephrectomy versus radical nephrectomy for non-metastatic pathological T3a renal cell carcinoma: a multi-institutional comparative analysis. Int J Urol 21:352–357

    Article  PubMed  Google Scholar 

  • Patard JJ, Shvarts O, Lam JS, Pantuck AJ, Kim HL, Ficarra V, Cindolo L, Han KR, De La Taille A, Tostain J, Artibani W, Abbou CC, Lobel B, Chopin DK, Figlin RA, Mulders PF, Belldegrun AS (2004) Safety and efficacy of partial nephrectomy for all T1 tumors based on an international multicenter experience. J Urol 171:2181–2185 (quiz 2435)

    Article  PubMed  Google Scholar 

  • Sprenkle PC, Power N, Ghoneim T, Touijer KA, Dalbagni G, Russo P, Coleman JA (2012) Comparison of open and minimally invasive partial nephrectomy for renal tumors 4–7 centimeters. Eur Urol 61:593–599

    Article  PubMed  Google Scholar 

  • Springer C, Hoda MR, Fajkovic H, Pini G, Mohammed N, Fornara P, Greco F (2013) Laparoscopic vs open partial nephrectomy for T1 renal tumours: evaluation of long-term oncological and functional outcomes in 340 patients. BJU Int 111:281–288

    Article  PubMed  Google Scholar 

  • Stephen B, Edge AGF, Byrd DR, Greene FL, Compton CC, Trotti A (2009) American Joint Committee on Cancer (AJCC) staging manual, 7th edn. Springer, Chicago

    Google Scholar 

  • van Oostenbrugge TJ, Kroeze SG, Bosch JL, van Melick HH (2015) The blind spots in follow-up after nephrectomy or nephron-sparing surgery for localized renal cell carcinoma. World J Urol 33:881–887

    Article  PubMed  Google Scholar 

  • Yossepowitch O, Thompson RH, Leibovich BC, Eggener SE, Pettus JA, Kwon ED, Herr HW, Blute ML, Russo P (2008) Positive surgical margins at partial nephrectomy: predictors and oncological outcomes. J Urol 179:2158–2163

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea

    Chunwoo Lee

  2. Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Dalsan You, Sangjun Yoo, Cheryn Song, Bumsik Hong, Jun Hyuk Hong, Hanjong Ahn & Choung-Soo Kim

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  1. Chunwoo Lee
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  2. Dalsan You
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  3. Sangjun Yoo
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  4. Cheryn Song
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  5. Bumsik Hong
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  6. Jun Hyuk Hong
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  7. Hanjong Ahn
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  8. Choung-Soo Kim
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Correspondence to Choung-Soo Kim.

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The authors report no conflict of interest.

Ethical approval

This study was performed with the approval and oversight of the Institutional Review Board of Asan Medical Center.

Human rights

This article does not contain any studies on human participants that were performed by any of the authors.

Informed consent

Informed consent was not obtained from all of the individual participants included in this study because of its retrospective design.

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Lee, C., You, D., Yoo, S. et al. Oncological outcomes of patients with incidental pathological T3a stage small renal cell carcinoma after partial nephrectomy. J Cancer Res Clin Oncol 142, 1651–1657 (2016). https://doi.org/10.1007/s00432-016-2172-x

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  • DOI: https://doi.org/10.1007/s00432-016-2172-x

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