10 cm'den büyük böbrek hücreli kanserli hastaların klinik ve histopatolojik özellikleri

Year 2022, , 44 - 47, 25.08.2022

Adem Emrah Coğuplugil , Selahattin Bedir

https://doi.org/10.29228/anatoljhr.58174

Abstract

Amaç: Bu çalışmada >10 cm böbrek kanseri (BK) olan hastaların klinik ve histopatolojik özelliklerini değerlendirmeyi amaçladık.
Yöntem: BK nedeniyle radikal/parsiyel nefrektomi yapılan hastaların verileri geriye dönük olarak değerlendirildi. Hastalar tümör boyutlarına göre (≤10 cm ve >10 cm) iki gruba ayrıldı. Demografik özellikler, histolojik tümör alt tipi, tümör derecesi, nefrektomi sonrası sağkalım ve metastaz verileri kaydedildi.
Bulgular: 116 hastanın verileri analiz edildi. Hastaların ortalama yaşı 57.6 idi. Ortalama tümör boyutu ameliyat öncesi tomografide 50 mm (dağılım: 15-150) mm ve patoloji örneğinde 50 mm (dağılım: 10-140) idi. Ortalama takip süresi 24.59±12.95 aydı. Çalışmaya dahil edilen 116 hastanın tümör boyutu 15 hastada >10 cm (grup 1), 101 hastada ≤10 cm (grup 2) idi. Grup 1'deki tüm hastalara radikal nefrektomi yapıldı. Grup 2'de 49 hastaya (%48.5) parsiyel nefrektomi ve 52 hastaya (%51.5) radikal nefrektomi uygulandı. Daha yüksek evre ve daha yüksek derece insidansı grup 1'de grup 2'ye göre anlamlı derecede yüksekti (p<0.05). Grup 1'de 3 (%20) hastada ve grup 2'de 5 (%4.9) hastada uzak metastaz mevcuttu (p<0.05). Kansere özgü sağkalım (KÖS), grup 2'de grup 1'e göre anlamlı olarak daha yüksekti (%96.1'e karşı %86.6, p<0.05).
Sonuçlar: >10 cm BK olan hastalarda metastaz oranı daha yüksek ve KÖS daha düşüktür. Bu hastalar metastaz açısından daha dikkatli takip edilmelidir.

Keywords

evre, histolojik tip, metastaz, böbrek kanseri, derece

Clinical and histopathological characteristics of patients with renal cell cancer larger than 10 cm

Abstract

Aim: In this study, we aimed to evaluate the clinical and histopathological characteristics of patients with renal cell cancer (RCC) > 10 cm.
Methods: Data of patients who underwent radical/partial nephrectomy due RCC were retrospectively evaluated. Patients were divided into two groups according to their tumor sizes (≤10 cm and >10 cm). The data of demographics, histological tumor subtype, tumor grade, survival after nephrectomy, and metastasis were recorded.
Results: Data from 116 patients were analysed. Mean age of the patients was 57.6 years. The mean tumour size was 50 (range: 15-150) mm in preoperative tomography, and 50 (range: 10-140) mm in pathology specimen. Mean follow up of time was 24.59±12.95 months. Out of 116 patients included in the study, tumour size were >10 cm in 15 patients (group 1) and ≤10 cm in 101 patients (group 2). Radical nephrectomy was performed to all patients in group 1. In group 2, 49 (48.5%) patients underwent partial nephrectomy and 52 (51.5%) patients underwent radical nephrectomy. The incidence of higher stage and higher grade in group 1 was significantly higher than group 2 (p<0.05). Distant metastasis was present in 3 (20%) patients from group 1 and 5 (4.9%) patients from group 2 (p<0.05). Cancer specific survival (CSS) was significantly higher in group 2 than in group 1 (96.1% vs. 86.6%, p<0.05).
Conclusion: Patients with RCC >10 cm have a higher metastasis rate and lower CSS. These patients should be followed more carefully for metastasis.

Keywords

grade, histologic type, metastasis, renal cell carcinoma, stage

References

• Cheville, J. C., Blute, M. L., Zincke, H., Lohse, C. M., & Weaver, A. L. (2001). Stage pT1 conventional (clear cell) renal cell carcinmoa: pathological features associated with cancer specific survival. Journal of Urology, 166(2), 453-456.
• Delahunt, B., Bethwaite, P. B., & Nacey, J. N. (2007). Outcome prediction for renal cell carcinoma: evaluation of prognostic factors for tumours divided according to histological subtype. Pathology, 39, 459-465.
• Dorin, R., Jackson, M., Cusano, A., Haddock, P., Kiziloz, H., Meraney, A., & Shichman, S. (2014). Active surveillance of renal masses: an analysis of growth kinetics and clinical outcomes stratified by radiological characteristics at diagnosis. International Brazilian Journal of Urology, 40(5), 627-636.
• Frank, I., Blute, M. L., Cheville, J. C., Lohse, C. M., Weaver, A. L., Leibovich, B. C., & Zincke, H. (2003). A multifactorial postoperative surveillance model for patients with surgically treated clear cell renal cell carcinoma. Journal of Urology, 170, 2225-2232.
• Frank, I., Blute, M. L., Leibovich, B. C., Cheville, J. C., Lohse, C. M., Kwon, E. D., & Zincke, H. (2005). pT2 classification for renal cell carcinoma. Can its accuracy be improved? Journal of Urology, 173(2), 380-384.
• Hamidi, N., Süer, E., Gökçe, I., Bedük, Y., & Baltacı, S. (2017). The effect of tumor size on oncologic outcomes in pathological T2 stage renal cell carcinoma patients. Bulletin of Urooncology, 16, 1-3.
• Karakiewicz, P. I., Briganti, A., Chun, F. K., Trinh, Q. D., Perrotte, P., Ficarra, V.,… & Patard, J. J. (2007). Multi-institutional validation of a new renal cancer-specific survival nomogram. Journal of Clinical Oncology, 25(11), 1316-1322.
• Lee, S. E., Lee, W. K., Kim, D. S., Doo, S. H., Park, H. Z., Yoon, C. Y.,… & Hong, S. K. (2010). Comparison of radiographic and pathologic sizes of renal tumours. World Journal of Urology, 28(3), 263-267.
• Leibovich, B. C., Lohse, C. M., Crispen, P. L., Boorjian, S. A., Thompson, R. H., Blute, M. L., & Cheville, J. C. (2010). Histological subtype is an independent predictor of outcome for patients with renal cell carcinoma. Journal of Urology, 183(4), 1309-1315.
• Ljungberg, B., Albiges, L., Bedke, J., Bex, A., Capitanio, U., Giles, R. H.,… & Tahbaz, R. (2021). EAU guideline on renal cell carcinoma. European Association of Urology, http://uroweb.org/guideline/renal-cell-carcinoma
• Mason, R. J., Abdolell, M., Trottier, G., Pringle, C., Lawen, J. G., Bell, D. G.,… & Rendon, R. A. (2011). Growth kinetics of renal masses: analysis of a prospective cohort of patients undergoing active surveillance. European Urology, 59(5), 863-867.
• Moch, H., Cubilla, A. L., Humphrey, P. A., Reuter, V. E., & Ulbright, T. M. (2016). The 2016 WHO classification of tumours of the urinary system and male genital organs-part A: Renal, penile, and testicular tumours. European Urology, 70(1), 93-105.
• Patard, J. J., Leray, E., Rioux-Leclercq, N., Cindolo, L., Ficarra, V., Zisman, A.,… & Pantuck, A. J. (2005). Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience. Journal of Clinical Oncology, 23(12), 2763-2771.
• Sun M, Lughezzani, G., Jeldres, C., Isbarn, H., Shariat, S.F., Arjane, P.,… & Karakiewicz, P. I. (2009). A proposal for reclassification of the Fuhrman grading system in patients with clear cell renal cell carcinoma. European Urology, 56(5), 775-781.
• Sun, M., Shariat, S. F., & Karakiewicz, P. I. (2010). Factors affecting outcome in renal cell carcinoma. Current Opinion in Urology, 20(5), 355-360.
• Yaycioglu, O., Rutman, M. P., Balasubramaniam, M., Peters, K. M., & Gonzalez, J. A. (2002). Clinical and pathologic tumour size in renal cell carcinoma; difference, correlation, and analysis of the influencing factors. Urology, 60(1), 33-38.
• Waalkes, S., Becker, F., Schrader, A. J., Janssen, M., Wegener, G., Merseburger, A. S., … & Kuczyk, M. A. (2011). Is there a need to further subclassify pT2 renal cell cancers as implemented by the revised 7th TNM version? European Urology, 59(2), 258-263.