1. Perinephric invasion as a prognostic factor in non-metastatic renal cell carcinoma: analysis of a nation-wide registry program.
- Author
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Kume H, Homma Y, Shinohara N, Obara W, Kondo T, Kimura G, Fujimoto H, Nonomura N, Hongo F, Sugiyama T, Takahashi M, Kanayama HO, Fukumori T, and Eto M
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Cohort Studies, Female, Humans, Male, Middle Aged, Multivariate Analysis, Neoplasm Invasiveness, Neoplasm Staging, Prognosis, Risk Factors, Thrombosis pathology, Young Adult, Carcinoma, Renal Cell pathology, Kidney pathology, Kidney Neoplasms pathology, Registries
- Abstract
Objectives: Perinephric fat invasion (PFI) of renal cell carcinoma (RCC) is known to be associated with adverse pathological features and poor prognosis. We analyzed these associations using a sub-group of the RCC registry of The Cancer Registration Committee of the Japanese Urological Association., Methods: The study cohort of 2998 non-metastatic cases was retrieved from RCC registry (3648 in total). We compared clinicopathological characteristics of cases with PFI (n = 256) and without PFI (n = 2742), and investigated the impact of PFI on cancer-specific survival using univariate and multivariate analyses., Results: Compared with non-PFI cases, PFI cases were older (P = 0.003), and more likely to be hypertensive (P = 0.034) and symptomatic at presentation (P < 0.001). PFI tumors were larger (P < 0.001), and more often have sarcomatoid component (P < 0.001) and tumor thrombus (P < 0.001). Cancer-specific survival was significantly shorter in cases with PFI than without (P < 0.001). The difference in survival tended to be greater in cases with large tumors but was significant in small tumor sub-groups. Cancer-specific survival was significantly shorter in cases with both PFI and renal vein involvement (RVI) in comparison to those with PFI or RVI alone (P = 0.011, P = 0.007, respectively). On multivariate analysis PFI with and without sinus fat invasion remained as an independent risk factor along with symptom at presentation, low body mass index, hypertension, multiple tumors, large tumor size (>7.0 cm), sarcomatoid component and RVI., Conclusions: PFI was associated with advanced age and aggressive pathological features. PFI is an independent prognostic factor in non-metastatic RCC., (© The Author(s) 2019. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2019
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