A Multi-institutional Study on Histopathological Characteristics of Surgically Treated Renal Tumors: the Importance of Tumor Size.
10.3349/ymj.2008.49.4.639
- Author:
Sun Il KIM
1
;
Yeung Deuk CHOI
;
Se Joong KIM
;
Byung Ha CHUNG
;
Do Hwan SEONG
;
Chun Il KIM
;
Sang Hyeon CHEON
;
Jin Seon CHO
;
Yun Seob SONG
;
Young Sig KIM
;
In Rae CHO
;
Dong Hyeon LEE
;
Ki Hak SONG
;
Hong Sup KIM
;
Joong Shik LEE
;
Won Jae YANG
;
Sung Joon HONG
Author Information
1. Department of Urology, Ajou University School of Medicine, Suwon, Korea. sjhong346@yuhs.ac
- Publication Type:Original Article ; Multicenter Study
- Keywords:
Kidney neoplasms;
renal cell carcinoma;
nephrectomy;
surgical pathology
- MeSH:
Adolescent;
Adult;
Aged;
Aged, 80 and over;
Female;
Humans;
Kidney Neoplasms/classification/*pathology/*surgery;
Male;
Middle Aged;
Neoplasm Staging
- From:Yonsei Medical Journal
2008;49(4):639-646
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The incidence of accidentally detected small renal tumors is increasing throughout the world. In this multi-institutional study performed in Korea, histopathological characteristics of contemporarily surgically removed renal tumors were reviewed with emphasis on tumor size. MATERIALS and METHODS: Between January 1995 and May 2005, 1,702 patients with a mean age of 55 years underwent surgical treatment at 14 training hospitals in Korea for radiologically suspected malignant renal tumors. Clinicopathological factors and patient survival were analyzed. RESULTS: Of the 1,702 tumors, 91.7% were malignant and 8.3% were benign. The percentage of benign tumors was significantly greater among those < or = 4cm (13.2%) than those > 4cm (4.5%) (p < 0.001). Among renal cell carcinoma patients, the percentage of tumors classed as stage > or = T3 was significantly less among tumors < or = 4cm (5.2%) than those > 4cm (26.8%) (p < 0.001). The percentage of tumors classed as Fuhrman's nuclear grades > or = 3 was also significantly less among tumors < or = 4cm (27.3%) than tumors > 4cm (50.9%) (p < 0.001). The 5-year cancer-specific survival rate was 82.7%, and T stage (p < 0.001), N stage (p < 0.001), M stage (p = 0.025), and Fuhrman's nuclear (p < 0.001) grade were the only independent predictors of cancer-specific survival. CONCLUSION: In renal tumors, small tumor size is prognostic for favorable postsurgical histopathologies such as benign tumors, low T stages, and low Fuhrman's nuclear grades. Our observations are expected to facilitate urologists to adopt function-preserving approach in the planning of surgery for small renal tumors with favorable predicted outcomes.
