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Outcomes of curative nephrectomy against renal cell carcinoma based on a central pathological review of 914 specimens from the era of cytokine treatment

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Abstract

Background

The purpose of this study was to determine the state of modern practice with regard to renal cell carcinoma (RCC) outcomes and to assess the effects on survival of such clinical and pathological factors such as histological subtype (HS) and nuclear grade by conducting a central pathological review based on the current World Health Organization classification and the staging system of the American Joint Committee on Cancer/Union for International Cancer Control.

Methods

We collected glass slides and clinical data sets for 914 cases of RCC treated with curative nephrectomy from 1995 to 2000. Overall (OS), cancer-specific (CSS), and relapse-free (RFS) survival were compared for HS and nuclear grades determined by a central pathology review board comprising 5 board-certified pathologists, pathological staging, and a variety of clinical factors.

Results

The 5 and 7-year CSS in this study were 96 and 93 %, respectively, values superior to those reported in Western countries. Concordance between the original and reviewed HS and nuclear grades were 90.9 and 21.1 %, respectively. HS correlated with OS (P = 0.043) but was not an independent prognostic factor in the multivariate analysis (P = 0.820). Tumor size, Fuhrman grade, and infiltration type were common independent prognostic factors for OS, CSS, and RFS.

Conclusions

This study revealed RCC outcomes in the era of cytokine treatment for metastasis. Central pathological review is an essential component of a multicenter study with long-term follow-up. Tumor size, Fuhrman grade, and infiltration type had much greater effects than HS on survival after curative nephrectomy.

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Acknowledgments

We thank Drs F. Kono, Y. Kotani, T Manabe, and Y. Nagashima for participation in the central pathology review and Dr M. Fukushima for study design. We also thank Drs T. Hayashi, Y. Nishio, K. Nishimura, Y. Taki, M. Nonomura, T. Hashimura, T. Matsuda, K. Ogura, H. Kanamaru, Y. Kakehi, A. Terai, M. Kawakita, M. Nishimura, H. Okuno, S. Fukuzawa, K. Okumura, Y. Shichiri, T. Ueda, H. Onishi, and H. Kinoshita for data collection. Support for this study was provided by Kyoto University, and partial support was provided by Pfizer, Inc. as Investigator-Initiated Research.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Urology, Nishi-Kobe Medical Center, Kobe, 651-2273, Japan

    Noriyuki Ito

  2. Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan

    Shinsuke Kojima

  3. Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Satoshi Teramukai

  4. Department of Diagnostic Pathology, Kumamoto University Hospital, Kumamoto, Japan

    Yoshiki Mikami

  5. Department of Urology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Osamu Ogawa & Tomomi Kamba

Authors
  1. Noriyuki Ito
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  2. Shinsuke Kojima
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  3. Satoshi Teramukai
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  4. Yoshiki Mikami
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  5. Osamu Ogawa
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  6. Tomomi Kamba
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Corresponding author

Correspondence to Noriyuki Ito.

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Ito, N., Kojima, S., Teramukai, S. et al. Outcomes of curative nephrectomy against renal cell carcinoma based on a central pathological review of 914 specimens from the era of cytokine treatment. Int J Clin Oncol 20, 1161–1170 (2015). https://doi.org/10.1007/s10147-015-0840-5

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  • DOI: https://doi.org/10.1007/s10147-015-0840-5

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