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Kidney Cancer pp 423-436 | Cite as

Staging and Reporting of Renal Cell Carcinomas

  • Antonio Lopez-Beltran
  • Maria R. Raspollini
  • Liang Cheng
  • Marina Scarpelli
  • Alessia Cimadamore
  • Matteo Santoni
  • Silvia Gasparrini
  • Rodolfo Montironi
Chapter

Abstract

This chapter is devoted to staging and reporting renal cell carcinoma (RCC) specimens and applies to both radical nephrectomy and partial nephrectomy (including tumorectomy) specimens [1–4]. Main issues to be considered have been covered thoroughly in the literature with significant differences between different AJCC classifications [1–39] (Fig. 21.1). Since January 2018 is the official call for implementing the AJCC Cancer Staging System, 8th Edition, in practice, we will provide along the next pages, a brief discussion of relevant changes incorporated in the 8th Edition as compared to the previous one.

Keywords

Staging renal cell carcinoma Staging of kidney specimens Kidney cancer staging Radical nephrectomy Partial nephrectomy Reporting renal cell carcinomas 

References

  1. 1.
    Amin MB, Edge S, Greene F, Byrd DR, Brookland RK et al., editors. American Joint Committee on Cancer (AJCC) staging manual. 8th ed. Switzerland: Springer; 2017.Google Scholar
  2. 2.
    Trpkov K, Grignon DJ, Bonsib SM, Amin MB, Billis A, Lopez-Beltran A, Samaratunga H, Tamboli P, Delahunt B, Egevad L, Montironi R, Srigley JR, members of the ISUP Renal Tumor Panel. Handling and staging of renal cell carcinoma. The International Society of Urological Pathology Consensus (ISUP) conference recommendations. Am J Surg Pathol. 2013;37:1505–17.CrossRefGoogle Scholar
  3. 3.
    Moch H, Humphrey PA, Ulbright TM, Reuter VE. World Health Organization (WHO) classification of tumours of the urinary system and male genital organs, vol. 8. 4th ed. Lyon: International Agency for Research on Cancer, cop.; 2016.Google Scholar
  4. 4.
    Delahunt B, Srigley JR, Amin MB, Billis A, Camparo P, Evans AJ, Fleming S, Griffiths D, Lopez-Beltran A, Martignoni G, Moch H, Nacey JN, Zhou M. Invasive carcinoma of renal tubular origin, histopathology reporting guide. 1st ed. Sydney: International Collaboration on Cancer Reporting; 2017. isbn:978-1-925687-00-2.Google Scholar
  5. 5.
    Bonsib S. Renal veins and venous extension in clear cell renal carcinoma. Mod Pathol. 2007;20:44–53.CrossRefGoogle Scholar
  6. 6.
    Greene F, Page D, Fleming I. American Joint Committee on cancer staging manual. 6th ed. New York: Springer; 2002. p. 131–44.CrossRefGoogle Scholar
  7. 7.
    Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A. American Joint Committee on Cancer (AJCC) cancer staging manual. 7th ed. Chicago: Springer, Inc; 2010.Google Scholar
  8. 8.
    Srigley JR, Delahunt B, Eble JN, et al. The International Society of Urological Pathology (ISUP) Vancouver Classification of renal neoplasia. Am J Surg Pathol. 2013;37:1469–89.CrossRefGoogle Scholar
  9. 9.
    Novara G, Ficarra V, Antonelli A, et al. Validation of the 2009 TNM version in a large multi-institutional cohort of patients treated for renal cell carcinoma: are further improvements needed? Eur Urol. 2010;58:588–95.CrossRefGoogle Scholar
  10. 10.
    Lopez-Beltran A, Scarpelli M, Montironi R, Kirkali Z. WHO classification of the renal tumors of the adults. Eur Urol. 2006;49:798–805.CrossRefGoogle Scholar
  11. 11.
    Algaba F, Trias I, Scarpelli M, et al. Handling and pathology reporting of renal tumor specimens. Eur Urol. 2004;45:437–43.CrossRefGoogle Scholar
  12. 12.
    Higgins JP, McKenney JK, Brooks JD, et al. Recommendations for the reporting of surgically resected specimens of renal cell carcinoma: the Association of Directors of Anatomic and Surgical Pathology. Hum Pathol. 2009;40:456–63.CrossRefGoogle Scholar
  13. 13.
    Lopez-Beltran A, Suzigan S, Montironi R, et al. Multilocular cystic renal cell carcinoma: a report of 45 cases of a kidney tumor of low malignant potential. Am J Clin Pathol. 2006;125:217–22.CrossRefGoogle Scholar
  14. 14.
    Eble JN. Recommendations for examining and reporting tumor-bearing kidney specimens from adults. Semin Diagn Pathol. 1998;15:77–82.PubMedGoogle Scholar
  15. 15.
    Bonsib SM. The renal sinus is the principal invasive pathway: a prospective study of 100 renal cell carcinomas. Am J Surg Pathol. 2004;28:1594–600.CrossRefGoogle Scholar
  16. 16.
    Thompson RH, Leibovich BC, Cheville JC, et al. Is renal sinus fat invasion the same as perinephric fat invasion for pT3a renal cell carcinoma? J Urol. 2005;174:1218–21.CrossRefGoogle Scholar
  17. 17.
    Grignon D, Paner GP. Renal cell carcinoma and the renal sinus. Adv Anat Pathol. 2007;14:63–8.CrossRefGoogle Scholar
  18. 18.
    Montironi R, Cheng L, Scarpelli M, Lopez-Beltran A. Pathology and genetics: tumours of the urinary system and male genital system: clinical implications of the 4th Edition of the WHO classification and beyond. Eur Urol. 2016;70(1):120–3.  https://doi.org/10.1016/j.eururo.2016.03.011.CrossRefPubMedGoogle Scholar
  19. 19.
    Bonsib SM. Renal lymphatics, and lymphatic involvement in sinus vein invasive (pT3b) clear cell renal cell carcinoma: a study of 40 cases. Mod Pathol. 2006;19:746–53.CrossRefGoogle Scholar
  20. 20.
    Bonsib SM. Renal veins and venous extension in clear cell renal cell carcinoma. Mod Pathol. 2007;20:44–53.CrossRefGoogle Scholar
  21. 21.
    Lopez-Beltran A, Cheng L, Raspollini MR, Montironi R. SMARCB1/INI1 genetic alterations in renal medullary carcinomas. Eur Urol. 2016;69(6):1062–4.  https://doi.org/10.1016/j.eururo.2016.01.002.CrossRefPubMedGoogle Scholar
  22. 22.
    Thompson RH, Blute ML, Krambeck AE, et al. Patients with pT1 renal cell carcinoma who die from disease after nephrectomy may have unrecognized renal sinus fat invasion. Am J Surg Pathol. 2007;31:1089–93.CrossRefGoogle Scholar
  23. 23.
    Frank I, Blute ML, Cheville JC, et al. Solid renal tumors: an analysis of pathological features related to tumor size. J Urol. 2003;170:2217–20.CrossRefGoogle Scholar
  24. 24.
    Lopez-Beltran A, Kirkali Z, Montironi R, Blanca A, Algaba F, Scarpelli M, Yorukoglu K, Hartmann A, Cheng L. Unclassified renal cell carcinoma: a report of 56 cases. BJU Int. 2012;110(6):786–93.  https://doi.org/10.1111/j.1464-410X.2012.10934.x.CrossRefPubMedGoogle Scholar
  25. 25.
    Verine J, Pluvinage A, Bousquet G, et al. Hereditary renal cancer syndromes: an update of a systematic review. Eur Urol. 2010;58:701–10.CrossRefGoogle Scholar
  26. 26.
    Richstone L, Scherr DS, Reuter VR, et al. Multifocal renal cortical tumors: frequency, associated clinicopathological features and impact on survival. J Urol. 2004;171:615–20.CrossRefGoogle Scholar
  27. 27.
    Zini L, Destrieux-Garnier L, Leroy X, et al. Renal vein ostium wall invasion of renal cell carcinoma with an inferior vena cava tumor thrombus: prediction by renal and vena caval vein diameters and prognostic significance. J Urol. 2008;179:450–4.CrossRefGoogle Scholar
  28. 28.
    Han KR, Bui MH, Pantuck AJ, et al. TNM T3a renal cell carcinoma: adrenal gland involvement is not the same as renal fat invasion. J Urol. 2003;169:899–903.CrossRefGoogle Scholar
  29. 29.
    Conti A, Santoni M, Sotte V, Burattini L, Scarpelli M, Cheng L, Lopez-Beltran A, Montironi R, Cascinu S, Muzzonigro G, Lund L. Small renal masses in the era of personalized medicine: tumor heterogeneity, growth kinetics, and risk of metastasis. Urol Oncol. 2015;33(7):303–9.CrossRefGoogle Scholar
  30. 30.
    Thompson RH, Leibovich BC, Cheville JC, et al. Should direct ipsilateral adrenal invasion from renal cell carcinoma be classified as pT3a? J Urol. 2005;173:918–21.CrossRefGoogle Scholar
  31. 31.
    Raspollini MR, Montagnani I, Montironi R, Cheng L, Martignoni G, Minervini A, Serni S, Nicita G, Carini M, Lopez-Beltran A. A contemporary series of renal masses with emphasis on recently recognized entities and tumors of low malignant potential: A report based on 624 consecutive tumors from a single tertiary center. Pathol Res Pract. 2017;213(7):804–8.CrossRefGoogle Scholar
  32. 32.
    Mehta V, Mudaliar K, Ghai R, et al. Renal lymph nodes for tumor staging: appraisal of 861 adult nephrectomies with microscopic examination of hilar fat. Arch Pathol Lab Med. 2013;137:1584.CrossRefGoogle Scholar
  33. 33.
    Terrone C, Guercio S, De Luca S, et al. The number of lymph nodes examined and staging accuracy in renal cell carcinoma. BJU Int. 2003;91:37–40.CrossRefGoogle Scholar
  34. 34.
    Crispen PL, Breau RH, Allmer C, et al. Lymph node dissection at the time of radical nephrectomy for high-risk clear cell renal cell carcinoma: indications and recommendations for surgical templates. Eur Urol. 2011;59:18–23.CrossRefGoogle Scholar
  35. 35.
    Shuch B, Amin A, Armstrong AJ, Eble JN, Ficarra V, Lopez-Beltran A, Martignoni G, Rini BI, Kutikov A. Understanding pathologic variants of renal cell carcinoma: distilling therapeutic opportunities from biologic complexity. Eur Urol. 2015;67(1):85–97.CrossRefGoogle Scholar
  36. 36.
    Delahunt B, Cheville JC, Martignoni G, et al. The International Society of Urological Pathology (ISUP) grading system for renal cell carcinoma and other prognostic parameters. Am J Surg Pathol. 2013;37:1490–504.CrossRefGoogle Scholar
  37. 37.
    Przybycin CG, McKenney JK, Reynolds JP, et al. Rhabdoid differentiation is associated with aggressive behavior in renal cell carcinoma: a clinicopathologic analysis of 76 cases with clinical follow-up. Am J Surg Pathol. 2014;38:1260–5.PubMedGoogle Scholar
  38. 38.
    Reuter VE, Argani P, Zhou M, Delahunt B, Amin MB, Epstein JI, Ulbright TM, Humphrey PA, Egevad L, Montironi R, Grignon D, Trpkov K, Lopez-Beltran A, Berney DM, Srigley JR. Best practice recommendations in the application of immunohistochemistry in kidney tumors; report for the International society of Urological Pathology consensus conference. Am J Surg Pathol. 2014;38:e35–49.CrossRefGoogle Scholar
  39. 39.
    Bijol V, Mendez GP, Hurwitz S, Rennke HG, Nose V. Evaluation of the non-neoplastic pathology in tumor nephrectomy specimens: predicting the risk of progressive failure. Am J Surg Pathol. 2006;30:575–84.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Antonio Lopez-Beltran
    • 1
  • Maria R. Raspollini
    • 2
  • Liang Cheng
    • 3
  • Marina Scarpelli
    • 4
  • Alessia Cimadamore
    • 5
  • Matteo Santoni
    • 6
  • Silvia Gasparrini
    • 7
  • Rodolfo Montironi
    • 4
  1. 1.Department of Pathology and SurgeryCordoba University School of MedicineCórdobaSpain
  2. 2.Histopathology and Molecular Diagnostics. University Hospital CareggiFlorenceItaly
  3. 3.Departments of Pathology, Urology, and Laboratory MedicineIndiana University School of MedicineIndianapolisUSA
  4. 4.Institute of Pathological Anatomy and Histopathology, United HospitalsAnconaItaly
  5. 5.Institute of Pathological Anatomy and Histopathology, University of the Marche RegionAnconaItaly
  6. 6.Oncology Unit, Macerata HospitalMacerataItaly
  7. 7.Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of MedicineAnconaItaly

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