Skip to main content

Advertisement

SpringerLink
Log in

Urinary collecting system invasion is no independent prognostic factor in renal cell carcinoma

  • Topic Paper
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Objectives

To assess the specific impact of urinary collecting system (UCS) invasion on the long-term prognosis of patients with renal cell carcinoma (RCC).

Methods

We evaluated 1,678 patients with complete information about UCS invasion of their primary RCC who had undergone renal surgery between 1990 and 2005 in two high volume centers (MH Hannover and Marburg, Germany); the mean follow-up was 5.4 years.

Results

Hundred and forty-nine (8.9%) patients demonstrated collecting system invasion. These patients incurred a significant increase in the likelihood of cancer-related death (HR 1.7, 95% CI: 1.4–2.0; P < 0.001), their median 5-year tumor-specific survival rate was 45% as opposed to 73% for patients without UCS invasion (P < 0.001). UCS invasion was significantly associated with tumor stage, grade, lymph node, and visceral metastasis at diagnosis but not with age, gender, histologic subtype, or body mass index. However, using multivariate analysis, UCS invasion disqualified as individual prognostic factor for RCC, neither for localized nor for advanced disease.

Conclusion

Facing the results of this large trial, we do not support the inclusion of UCS invasion into upcoming TNM staging systems. In contrast, future research should focus on novel molecular markers expressed by the tumor and/or specific immunological characteristics of patients with RCC which could improve prediction of RCC-associated prognosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Ficarra V, Galfano A, Novara G, Iafrate M, Brunelli M, Secco S, Cavalleri S, Martignoni G, Artibani W (2008) Risk stratification and prognostication of renal cell carcinoma. World J Urol 26:115–125

    Article  PubMed  Google Scholar 

  2. Fujita T, Iwamura M, Yanagisawa N, Muramoto M, Okayasu I, Baba S (2008) Reclassification of the current tumor, node, metastasis staging in pT3 renal cell carcinoma. Int J Urol 15:582–586

    Article  PubMed  Google Scholar 

  3. Kawata N, Nagane Y, Yamaguchi K, Ichinose T, Hirakata H, Takahashi S (2008) How do symptoms have an impact on the prognosis of renal cell carcinoma? Int J Urol 15:299–303

    Article  PubMed  Google Scholar 

  4. Brookman-Amissah S, May M, Albrecht K, Herrmann T, Roigas J, Gilfrich CP, Pflanz S, Gunia S (2009) Urinary collecting system invasion reflects adverse long- term outcome and is associated with simultaneous metastatic spread at the time of surgery and with multilocular dissemination during postsurgical follow-up in renal cell cancer. World J Urol 28:103–109

    Article  PubMed  Google Scholar 

  5. Klatte T, Chung J, Leppert JT, Lam JS, Pantuck AJ, Figlin RA, Belldegrun AS (2007) Prognostic relevance of capsular involvement and collecting system invasion in stage I and II renal cell carcinoma. BJU Int 99:821–824

    Article  PubMed  Google Scholar 

  6. Palapattu GS, Pantuck AJ, Dorey F, Said JW, Figlin RA, Belldegrun AS (2003) Collecting system invasion in renal cell carcinoma: impact on prognosis and future staging strategies. J Urol 170:768–772

    Article  PubMed  Google Scholar 

  7. Terrone C, Cracco C, Guercio S, Bollito E, Poggio M, Scoffone C, Tarabuzzi R, Porpiglia F, Scarpa RM, Fontana D, Rocca Rossetti S (2004) Prognostic value of the involvement of the urinary collecting system in renal cell carcinoma. Eur Urol 46:472–476

    Article  CAS  PubMed  Google Scholar 

  8. Uzzo RG, Cherullo EE, Myles J, Novick AC (2002) Renal cell carcinoma invading the urinary collecting system: implications for staging. J Urol 167:2392–2396

    Article  PubMed  Google Scholar 

  9. Verhoest G, Avakian R, Bensalah K, Thuret R, Ficarra V, Artibani W, Tostain J, Guille F, Cindolo L, De La Taille A, Abbou CC, Salomon L, Rioux-Leclercq N, Patard JJ (2009) Urinary collecting system invasion is an independent prognostic factor of organ confined renal cell carcinoma. J Urol 182:854–859

    Article  PubMed  Google Scholar 

  10. Storkel S, Eble JN, Adlakha K, Amin M, Blute ML, Bostwick DG, Darson M, Delahunt B, Iczkowski K (1997) Classification of renal cell carcinoma: workgroup no. 1. Union Internationale Contre le Cancer (UICC) and the American Joint Committee on Cancer (AJCC). Cancer 80:987–989

    Article  CAS  PubMed  Google Scholar 

  11. Gettman MT, Blute ML (2002) Update on pathologic staging of renal cell carcinoma. Urology 60:209–217

    Article  PubMed  Google Scholar 

  12. Harmer M (ed) (1978) tnm classification of malignant tumors. International Union against Cancer, Geneva

    Google Scholar 

  13. Liu Z, Lv J, Ding K, Fu Q, Cao Q, Wang F (2009) Validation of the current prognostic models for nonmetastatic renal cell carcinoma after nephrectomy in Chinese population: a 15-year single center experience. Int J Urol 16:268–273

    Article  PubMed  Google Scholar 

Download references

Conflict of interest statement

We certify that there is no actual or potential conflict of interest in relation to this article.

Author information

Authors and Affiliations

  1. Department of Urology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Sandra Waalkes, Axel S. Merseburger, Thomas R. W. Herrmann, Mario W. Kramer, Gerd Wegener & Markus A. Kuczyk

  2. Department of Urology, Philipps-University Medical School, Baldingerstrasse, 35043, Marburg, Germany

    Julia Rustemeier, Rainer Hofmann & Andres J. Schrader

  3. Department of Urology, Ulm-University Medical School, Prittwitzstraße 43, 89075, Ulm, Germany

    Andres J. Schrader

Authors
  1. Sandra Waalkes
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Axel S. Merseburger
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Thomas R. W. Herrmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mario W. Kramer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gerd Wegener
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Julia Rustemeier
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Rainer Hofmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Markus A. Kuczyk
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Andres J. Schrader
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Markus A. Kuczyk.

Additional information

Sandra Waalkes and Axel S. Merseburger contributed equally to this work.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Waalkes, S., Merseburger, A.S., Herrmann, T.R.W. et al. Urinary collecting system invasion is no independent prognostic factor in renal cell carcinoma. World J Urol 28, 283–288 (2010). https://doi.org/10.1007/s00345-010-0526-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-010-0526-6

Keywords

Search

Navigation