Prognostic Relevance of Tumour Size in T3a Renal Cell Carcinoma: A Multicentre Experience
Abstract Objective To evaluate the prognostic role of tumour size in pathological stage T3a renal cell carcinoma (RCC) with fat invasion only and to assess whether this subgroup maintains its relevance over the other pathological stages. Methods We retrospectively studied 2113 patients from eight in...
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| Veröffentlicht in: | European urology 2007-07, Vol.52 (1), p.155-162 |
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| creator | Lam, John S Klatte, Tobias Patard, Jean-Jacques Goel, Rakhee H Guillè, François Lobel, Bernard Abbou, Clement-Claude De La Taille, Alexandre Tostain, Jacques Cindolo, Luca Altieri, Vincenzo Ficarra, Vincenzo Artibani, Walter Prayer-Galetti, Tommaso Schips, Luigi Zigeuner, Richard Pantuck, Allan J Figlin, Robert A Belldegrun, Arie S |
| description | Abstract Objective To evaluate the prognostic role of tumour size in pathological stage T3a renal cell carcinoma (RCC) with fat invasion only and to assess whether this subgroup maintains its relevance over the other pathological stages. Methods We retrospectively studied 2113 patients from eight international institutions who were treated by surgical resection for T2–4 RCC. Disease-specific survival (DSS) was evaluated with univariate and multivariate analyses. Results Univariate analysis of patients with T3a RCC showed that tumour size was significantly associated with DSS (HR: 1.09, 95% CI: 1.05–1.12, p < 0.001). An ideal cut-off of 7 cm for these patients was identified with a scatter plot of Martingale residuals and tumour size. The two T3a groups were distinctly different with respect to clinicopathologic parameters (performance status, metastases, grade, histological subtype) and survival ( p < 0.001). Median survival time was not reached for patients with T2 and T3a ≤ 7 cm disease with a 5- and 10-yr DSS rate of 70% and 59% and 63% and 53%, respectively. Median survival time for patients with T3a > 7 cm, T3b, T3c, and T4 disease was 54, 46, 21, and 11 mo, respectively, with 5- and 10-yr DSS rates of 46% and 36%, 46% and 36%, 34% and 0%, and 16% and 14%, respectively. Conclusions Our data indicate that tumour size is an important factor for predicting outcome of patients with T3a RCC with fat invasion only. Our findings should merit consideration during the next revision of the TNM classification. |
| doi_str_mv | 10.1016/j.eururo.2007.01.106 |
| format | Article |
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Methods We retrospectively studied 2113 patients from eight international institutions who were treated by surgical resection for T2–4 RCC. Disease-specific survival (DSS) was evaluated with univariate and multivariate analyses. Results Univariate analysis of patients with T3a RCC showed that tumour size was significantly associated with DSS (HR: 1.09, 95% CI: 1.05–1.12, p < 0.001). An ideal cut-off of 7 cm for these patients was identified with a scatter plot of Martingale residuals and tumour size. The two T3a groups were distinctly different with respect to clinicopathologic parameters (performance status, metastases, grade, histological subtype) and survival ( p < 0.001). Median survival time was not reached for patients with T2 and T3a ≤ 7 cm disease with a 5- and 10-yr DSS rate of 70% and 59% and 63% and 53%, respectively. Median survival time for patients with T3a > 7 cm, T3b, T3c, and T4 disease was 54, 46, 21, and 11 mo, respectively, with 5- and 10-yr DSS rates of 46% and 36%, 46% and 36%, 34% and 0%, and 16% and 14%, respectively. Conclusions Our data indicate that tumour size is an important factor for predicting outcome of patients with T3a RCC with fat invasion only. Our findings should merit consideration during the next revision of the TNM classification.</description><identifier>ISSN: 0302-2838</identifier><identifier>EISSN: 1873-7560</identifier><identifier>DOI: 10.1016/j.eururo.2007.01.106</identifier><identifier>PMID: 17316970</identifier><identifier>CODEN: EUURAV</identifier><language>eng</language><publisher>Oxford: Elsevier</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Austria - epidemiology ; Biological and medical sciences ; California - epidemiology ; Carcinoma, Renal Cell - classification ; Carcinoma, Renal Cell - mortality ; Carcinoma, Renal Cell - pathology ; Child ; Female ; Follow-Up Studies ; France - epidemiology ; Humans ; Italy - epidemiology ; Kidney Neoplasms - classification ; Kidney Neoplasms - mortality ; Kidney Neoplasms - pathology ; Kidneys ; Male ; Medical sciences ; Middle Aged ; Neoplasm Staging ; Nephrology. Urinary tract diseases ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Survival Rate - trends ; Time Factors ; Tumors of the urinary system ; Urology</subject><ispartof>European urology, 2007-07, Vol.52 (1), p.155-162</ispartof><rights>European Association of Urology</rights><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c390t-6479102b25535032067664342d41b76d63bf6a1a4d742f3500e4207e81813f043</citedby><cites>FETCH-LOGICAL-c390t-6479102b25535032067664342d41b76d63bf6a1a4d742f3500e4207e81813f043</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18812118$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17316970$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lam, John S</creatorcontrib><creatorcontrib>Klatte, Tobias</creatorcontrib><creatorcontrib>Patard, Jean-Jacques</creatorcontrib><creatorcontrib>Goel, Rakhee H</creatorcontrib><creatorcontrib>Guillè, François</creatorcontrib><creatorcontrib>Lobel, Bernard</creatorcontrib><creatorcontrib>Abbou, Clement-Claude</creatorcontrib><creatorcontrib>De La Taille, Alexandre</creatorcontrib><creatorcontrib>Tostain, Jacques</creatorcontrib><creatorcontrib>Cindolo, Luca</creatorcontrib><creatorcontrib>Altieri, Vincenzo</creatorcontrib><creatorcontrib>Ficarra, Vincenzo</creatorcontrib><creatorcontrib>Artibani, Walter</creatorcontrib><creatorcontrib>Prayer-Galetti, Tommaso</creatorcontrib><creatorcontrib>Schips, Luigi</creatorcontrib><creatorcontrib>Zigeuner, Richard</creatorcontrib><creatorcontrib>Pantuck, Allan J</creatorcontrib><creatorcontrib>Figlin, Robert A</creatorcontrib><creatorcontrib>Belldegrun, Arie S</creatorcontrib><title>Prognostic Relevance of Tumour Size in T3a Renal Cell Carcinoma: A Multicentre Experience</title><title>European urology</title><addtitle>Eur Urol</addtitle><description>Abstract Objective To evaluate the prognostic role of tumour size in pathological stage T3a renal cell carcinoma (RCC) with fat invasion only and to assess whether this subgroup maintains its relevance over the other pathological stages. Methods We retrospectively studied 2113 patients from eight international institutions who were treated by surgical resection for T2–4 RCC. Disease-specific survival (DSS) was evaluated with univariate and multivariate analyses. Results Univariate analysis of patients with T3a RCC showed that tumour size was significantly associated with DSS (HR: 1.09, 95% CI: 1.05–1.12, p < 0.001). An ideal cut-off of 7 cm for these patients was identified with a scatter plot of Martingale residuals and tumour size. The two T3a groups were distinctly different with respect to clinicopathologic parameters (performance status, metastases, grade, histological subtype) and survival ( p < 0.001). Median survival time was not reached for patients with T2 and T3a ≤ 7 cm disease with a 5- and 10-yr DSS rate of 70% and 59% and 63% and 53%, respectively. Median survival time for patients with T3a > 7 cm, T3b, T3c, and T4 disease was 54, 46, 21, and 11 mo, respectively, with 5- and 10-yr DSS rates of 46% and 36%, 46% and 36%, 34% and 0%, and 16% and 14%, respectively. Conclusions Our data indicate that tumour size is an important factor for predicting outcome of patients with T3a RCC with fat invasion only. Our findings should merit consideration during the next revision of the TNM classification.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Austria - epidemiology</subject><subject>Biological and medical sciences</subject><subject>California - epidemiology</subject><subject>Carcinoma, Renal Cell - classification</subject><subject>Carcinoma, Renal Cell - mortality</subject><subject>Carcinoma, Renal Cell - pathology</subject><subject>Child</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>France - epidemiology</subject><subject>Humans</subject><subject>Italy - epidemiology</subject><subject>Kidney Neoplasms - classification</subject><subject>Kidney Neoplasms - mortality</subject><subject>Kidney Neoplasms - pathology</subject><subject>Kidneys</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Survival Rate - trends</subject><subject>Time Factors</subject><subject>Tumors of the urinary system</subject><subject>Urology</subject><issn>0302-2838</issn><issn>1873-7560</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkU2LFDEQhoMo7rj6D0Ry0VuPVUk66fYgLMP6ASuKOx48hUxPtWTs7ozJ9OL6661hBvaSQOV5X8JTQrxEWCKgfbtb0pznnJYKwC0BeWofiQU2TleutvBYLECDqlSjmwvxrJQdAOi61U_FBTqNtnWwED-_5fRrSuUQO_mdBroLU0cy9XI9j2nO8jb-IxknudaB36cwyBUNfITcxSmN4Z28kl_mgeM0HTLJ6797ypG45Ll40oeh0IvzfSl-fLherz5VN18_fl5d3VSdbuFQWeNaBLVRda1r0Aqss9Zoo7YGN85urd70NmAwW2dUzwiQUeCowQZ1D0Zfijen3n1Of2YqBz_G0vEnw0RpLt5BXSujWwbNCexyKiVT7_c5jiHfewR_VOp3_qTUH5V6QJ5ajr0698-bkbYPobNDBl6fgVC6MPSZFcbywDUNKsSGufcnjtjGXaTsuyFOkSO_6Z7KjnWz3-LRF-XB3x63d1weOAA01un_i7WTJA</recordid><startdate>20070701</startdate><enddate>20070701</enddate><creator>Lam, John S</creator><creator>Klatte, Tobias</creator><creator>Patard, Jean-Jacques</creator><creator>Goel, Rakhee H</creator><creator>Guillè, François</creator><creator>Lobel, Bernard</creator><creator>Abbou, Clement-Claude</creator><creator>De La Taille, Alexandre</creator><creator>Tostain, Jacques</creator><creator>Cindolo, Luca</creator><creator>Altieri, Vincenzo</creator><creator>Ficarra, Vincenzo</creator><creator>Artibani, Walter</creator><creator>Prayer-Galetti, Tommaso</creator><creator>Schips, Luigi</creator><creator>Zigeuner, Richard</creator><creator>Pantuck, Allan J</creator><creator>Figlin, Robert A</creator><creator>Belldegrun, Arie S</creator><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20070701</creationdate><title>Prognostic Relevance of Tumour Size in T3a Renal Cell Carcinoma: A Multicentre Experience</title><author>Lam, John S ; Klatte, Tobias ; Patard, Jean-Jacques ; Goel, Rakhee H ; Guillè, François ; Lobel, Bernard ; Abbou, Clement-Claude ; De La Taille, Alexandre ; Tostain, Jacques ; Cindolo, Luca ; Altieri, Vincenzo ; Ficarra, Vincenzo ; Artibani, Walter ; Prayer-Galetti, Tommaso ; Schips, Luigi ; Zigeuner, Richard ; Pantuck, Allan J ; Figlin, Robert A ; Belldegrun, Arie S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c390t-6479102b25535032067664342d41b76d63bf6a1a4d742f3500e4207e81813f043</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Austria - epidemiology</topic><topic>Biological and medical sciences</topic><topic>California - epidemiology</topic><topic>Carcinoma, Renal Cell - classification</topic><topic>Carcinoma, Renal Cell - mortality</topic><topic>Carcinoma, Renal Cell - pathology</topic><topic>Child</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>France - epidemiology</topic><topic>Humans</topic><topic>Italy - epidemiology</topic><topic>Kidney Neoplasms - classification</topic><topic>Kidney Neoplasms - mortality</topic><topic>Kidney Neoplasms - pathology</topic><topic>Kidneys</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Survival Rate - trends</topic><topic>Time Factors</topic><topic>Tumors of the urinary system</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lam, John S</creatorcontrib><creatorcontrib>Klatte, Tobias</creatorcontrib><creatorcontrib>Patard, Jean-Jacques</creatorcontrib><creatorcontrib>Goel, Rakhee H</creatorcontrib><creatorcontrib>Guillè, François</creatorcontrib><creatorcontrib>Lobel, Bernard</creatorcontrib><creatorcontrib>Abbou, Clement-Claude</creatorcontrib><creatorcontrib>De La Taille, Alexandre</creatorcontrib><creatorcontrib>Tostain, Jacques</creatorcontrib><creatorcontrib>Cindolo, Luca</creatorcontrib><creatorcontrib>Altieri, Vincenzo</creatorcontrib><creatorcontrib>Ficarra, Vincenzo</creatorcontrib><creatorcontrib>Artibani, Walter</creatorcontrib><creatorcontrib>Prayer-Galetti, Tommaso</creatorcontrib><creatorcontrib>Schips, Luigi</creatorcontrib><creatorcontrib>Zigeuner, Richard</creatorcontrib><creatorcontrib>Pantuck, Allan J</creatorcontrib><creatorcontrib>Figlin, Robert A</creatorcontrib><creatorcontrib>Belldegrun, Arie S</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lam, John S</au><au>Klatte, Tobias</au><au>Patard, Jean-Jacques</au><au>Goel, Rakhee H</au><au>Guillè, François</au><au>Lobel, Bernard</au><au>Abbou, Clement-Claude</au><au>De La Taille, Alexandre</au><au>Tostain, Jacques</au><au>Cindolo, Luca</au><au>Altieri, Vincenzo</au><au>Ficarra, Vincenzo</au><au>Artibani, Walter</au><au>Prayer-Galetti, Tommaso</au><au>Schips, Luigi</au><au>Zigeuner, Richard</au><au>Pantuck, Allan J</au><au>Figlin, Robert A</au><au>Belldegrun, Arie S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic Relevance of Tumour Size in T3a Renal Cell Carcinoma: A Multicentre Experience</atitle><jtitle>European urology</jtitle><addtitle>Eur Urol</addtitle><date>2007-07-01</date><risdate>2007</risdate><volume>52</volume><issue>1</issue><spage>155</spage><epage>162</epage><pages>155-162</pages><issn>0302-2838</issn><eissn>1873-7560</eissn><coden>EUURAV</coden><abstract>Abstract Objective To evaluate the prognostic role of tumour size in pathological stage T3a renal cell carcinoma (RCC) with fat invasion only and to assess whether this subgroup maintains its relevance over the other pathological stages. Methods We retrospectively studied 2113 patients from eight international institutions who were treated by surgical resection for T2–4 RCC. Disease-specific survival (DSS) was evaluated with univariate and multivariate analyses. Results Univariate analysis of patients with T3a RCC showed that tumour size was significantly associated with DSS (HR: 1.09, 95% CI: 1.05–1.12, p < 0.001). An ideal cut-off of 7 cm for these patients was identified with a scatter plot of Martingale residuals and tumour size. The two T3a groups were distinctly different with respect to clinicopathologic parameters (performance status, metastases, grade, histological subtype) and survival ( p < 0.001). Median survival time was not reached for patients with T2 and T3a ≤ 7 cm disease with a 5- and 10-yr DSS rate of 70% and 59% and 63% and 53%, respectively. Median survival time for patients with T3a > 7 cm, T3b, T3c, and T4 disease was 54, 46, 21, and 11 mo, respectively, with 5- and 10-yr DSS rates of 46% and 36%, 46% and 36%, 34% and 0%, and 16% and 14%, respectively. Conclusions Our data indicate that tumour size is an important factor for predicting outcome of patients with T3a RCC with fat invasion only. Our findings should merit consideration during the next revision of the TNM classification.</abstract><cop>Oxford</cop><pub>Elsevier</pub><pmid>17316970</pmid><doi>10.1016/j.eururo.2007.01.106</doi><tpages>8</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Austria - epidemiology Biological and medical sciences California - epidemiology Carcinoma, Renal Cell - classification Carcinoma, Renal Cell - mortality Carcinoma, Renal Cell - pathology Child Female Follow-Up Studies France - epidemiology Humans Italy - epidemiology Kidney Neoplasms - classification Kidney Neoplasms - mortality Kidney Neoplasms - pathology Kidneys Male Medical sciences Middle Aged Neoplasm Staging Nephrology. Urinary tract diseases Prognosis Proportional Hazards Models Retrospective Studies Risk Factors Severity of Illness Index Survival Rate - trends Time Factors Tumors of the urinary system Urology |
| title | Prognostic Relevance of Tumour Size in T3a Renal Cell Carcinoma: A Multicentre Experience |
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