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Nason GJ, McGuire BB, Kelly ME, et al. Clinico-pathological analysis of renal cell carcinoma demonstrates decreasing tumour grade over a 17-year period. Can Urol Assoc J. 2014;8(3):125-32doi: 10.5489/cuaj.1721.
Nason, G. J., McGuire, B. B., Kelly, M. E., Murphy, T. M., Looney, A. T., Byrne, D. P., Mulvin, D. W., Galvin, D. J., Quinlan, D. M., & Lennon, G. M. (2014). Clinico-pathological analysis of renal cell carcinoma demonstrates decreasing tumour grade over a 17-year period. Canadian Urological Association journal = Journal de l'Association des urologues du Canada, 8(3), 125-32. https://doi.org/10.5489/cuaj.1721
Nason, Gregory J, et al. "Clinico-pathological analysis of renal cell carcinoma demonstrates decreasing tumour grade over a 17-year period." Canadian Urological Association journal = Journal de l'Association des urologues du Canada vol. 8,3 (2014): 125-32. doi: https://doi.org/10.5489/cuaj.1721
Nason GJ, McGuire BB, Kelly ME, Murphy TM, Looney AT, Byrne DP, Mulvin DW, Galvin DJ, Quinlan DM, Lennon GM. Clinico-pathological analysis of renal cell carcinoma demonstrates decreasing tumour grade over a 17-year period. Can Urol Assoc J. 2014 Mar;8(3):125-32. doi: 10.5489/cuaj.1721. PMID: 24839483; PMCID: PMC4001635.
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Can Urol Assoc J. 2014 Mar;8(3):125-32. doi: 10.5489/cuaj.1721.

Clinico-pathological analysis of renal cell carcinoma demonstrates decreasing tumour grade over a 17-year period.

Canadian Urological Association journal = Journal de l'Association des urologues du Canada

Gregory J Nason, Barry B McGuire, Michael E Kelly, Theodore M Murphy, Aisling T Looney, Damien P Byrne, David W Mulvin, David J Galvin, David M Quinlan, Gerald M Lennon

Affiliations

  1. Department of Urology, St Vincent's University Hospital, Dublin 4, Ireland.

PMID: 24839483 PMCID: PMC4001635 DOI: 10.5489/cuaj.1721

Abstract

INTRODUCTION: Renal cell carcinoma (RCC) represents about 3% of adult malignancies in Ireland. Worldwide there is a reported increasing incidence and recent studies report a stage migration towards smaller tumours. We assess the clinico-pathological features and survival of patients with RCC in a surgically treated cohort.

METHODS: A retrospective analysis of all nephrectomies carried out between 1995 and 2012 was carried out in an Irish tertiary referral university hospital. Data recorded included patient demographics, size of tumour, tumour-node-metastasis (TNM) classification, operative details and final pathology. The data were divided into 3 equal consecutive time periods for comparison purposes: Group 1 (1995-2000), Group 2 (2001-2006) and Group 3 (2007-2012). Survival data were verified with the National Cancer Registry of Ireland.

RESULTS: In total, 507 patients underwent nephrectomies in the study period. The median tumour size was 5.8 cm (range: 1.2-20 cm) and there was no statistical reduction in size observed over time (p = 0.477). A total of 142 (28%) RCCs were classified as pT1a, 111 (21.9%) were pT1b, 67 (13.2%) were pT2, 103 (20.3%) were pT3a, 75 (14.8%) were pT3b and 9 (1.8%) were pT4. There was no statistical T-stage migration observed (p = 0.213). There was a significant grade reduction over time (p = 0.017). There was significant differences noted in overall survival between the T-stages (p < 0.001), nuclear grades (p < 0.001) and histological subtypes (p = 0.022).

CONCLUSION: There was a rising incidence in the number of nephrectomies over the study period. Despite previous reports, a stage migration was not evident; however, a grade reduction was apparent in this Irish surgical series. We can demonstrate that tumour stage, nuclear grade and histological subtype are significant prognosticators of relative survival in RCC.

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