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01-02-2010 | Original Article

Urinary collecting system invasion reflects adverse long-term outcome and is associated with simultaneous metastatic spread at the time of surgery and with multilocular dissemination during postsurgical follow-up in renal cell cancer

Authors: Sabine Brookman-Amissah, Matthias May, Knut Albrecht, Thomas Herrmann, Jan Roigas, Christian Peter Gilfrich, Sandra Pflanz, Sven Gunia

Published in: World Journal of Urology | Issue 1/2010

Abstract

Objectives

To assess the prognostic implication of urinary collecting system invasion (CSI) in renal cell cancer (RCC).

Methods

Surveying a mean follow-up of 85 months, we investigated a cohort of 834 patients after radical (n = 710) or partial (n = 124) nephrectomy. At the time of surgery, 63 patients (7.6%) suffered from metastatic RCC. Various histopathologic parameters were analysed, and cancer specific survival (CSS) curves were individualized for each parameter. Furthermore, multivariate analysis was accomplished.

Results

Collecting system invasion was independently associated with a significant decline in CSS and was associated with simultaneous metastatic spread at the time of surgery and multilocular (involvement of at least two different organ systems) dissemination.

Conclusions

The prognostic implication of CSI in RCC appears to be more complex than expected. Therefore, pathologists should report on CSI to enable selection of patients to be investigated in prospective studies which are needed to clarify the prognostic role of CSI in RCC.

Chow WH, Devesa SS, Warren JL, Fraumeni JF Jr (1999) Rising incidence of renal cell cancer in the United States. JAMA 281(17):1628–1631. doi:10.1001/jama.281.17.1628 CrossRefPubMed

Parkin DM, Bray F, Ferlay J, Pisani P (2001) Estimating the world cancer burden: Globocan 2000. Int J Cancer 94(2):153–156. doi:10.1002/ijc.1440 CrossRefPubMed

Jayson M, Sanders H (1998) Increased incidence of serendipitously discovered renal cell carcinoma. Urology 51(2):203–205. doi:10.1016/S0090-4295(97)00506-2 CrossRefPubMed

Pantuck AJ, Zisman A, Belldegrun AS (2001) The changing natural history of renal cell carcinoma. J Urol 166(5):1611–1623. doi:10.1016/S0022-5347(05)65640-6 CrossRefPubMed

Van Poppel H, Vandendriessche H, Boel K, Mertens V, Goethuys H, Haustermans K, Van Damme B, Baert L (1997) Microscopic vascular invasion is the most relevant prognosticator after radical nephrectomy for clinically nonmetastatic renal cell carcinoma. J Urol 158(1):45–49. doi:10.1097/00005392-199707000-00013 CrossRefPubMed

Goncalves PD, Srougi M, Dall’lio MF, Leite KR, Ortiz V, Hering F (2004) Low clinical stage renal cell carcinoma: relevance of microvascular tumor invasion as a prognostic parameter. J Urol 172(2):470–474. doi:10.1097/01.ju.0000130582.31467.30 CrossRefPubMed

Janzen NK, Kim HL, Figlin RA, Belldegrun AS (2003) Surveillance after radical or partial nephrectomy for localized renal cell carcinoma and management of recurrent disease. Urol Clin North Am 30(4):843–852. doi:10.1016/S0094-0143(03)00056-9 CrossRefPubMed

Sobin LH, Wittekind CH (2002) International Union Against Cancer (UICC). TNM classification of malignant tumors, 6th edn. Wiley-Liss Publications, New York

Harmer MH (1978) TNM classification of malignant tumors. 3rd edn. Geneva 1978: International Union Against Cancer (UICC)

10.

Gettman MT, Blute ML (2002) Update on pathological staging of renal cell carcinoma. Urology 60(2):209–217. doi:10.1016/S0090-4295(02)01675-8 CrossRefPubMed

11.

Palapattu GS, Pantuck AJ, Dorey F, Said JF, Figlin RA, Belldegrun AS (2003) Collecting system invasion in renal cell carcinoma: impact on prognosis and future staging strategies. J Urol 170(3):768–772. doi:10.1097/01.ju.0000082580.13597.a2 CrossRefPubMed

12.

Uzzo RG, Cherullo EE, Myles J, Novick AC (2002) Renal cell carcinoma invading the urinary collecting system: implications for staging. J Urol 167(6):2392–2396. doi:10.1016/S0022-5347(05)64991-9 CrossRefPubMed

13.

Mickisch GH, Garin A, van Poppel H, de Prijck L, Sylvester R (2001) Radical nephrectomy plus interferon-alfa-based immunotherapy compared with interferon alfa alone in metastatic renal cell carcinoma: a randomised trial. Organisation for Research and Treatment of Cancer (EORTC) Genitourinary Group. Lancet 358(9286):966–970. doi:10.1016/S0140-6736(01)06103-7 CrossRefPubMed

14.

Flanigan RC, Salmon SE, Blumenstein BA, Bearman SI, Roy V, McGrath PC, Caton JR Jr, Munhi N, Crawford ED (2001) Nephrectomy followed by interferon alfa-2b compared with interferon alfa-2b alone for metastatic renal cell cancer. N Engl J Med 345(23):1655–1659. doi:10.1056/NEJMoa003013 CrossRefPubMed

15.

Thoenes W, Störkel S, Rumpelt HJ (1986) Histopathology and classification of Renal cell tumors (adenomas, oncocytomas and carcinomas). The basic cytological and histopathological elements and their use for diagnostics. Pathol Res Pract 181(2):125–143PubMed

16.

Kirkali Z, Algaba F, Scarpelli M, Trias I, Selvaggi FP, Van Poppel H (2007) What does the urologist expect from the pathologist (and what can the pathologist give) in reporting on adult kidney tumour specimens? Eur Urol 51(5):1194–1201. doi:10.1016/j.eururo.2006.11.024 CrossRefPubMed

17.

Kovacs G, Akhtar M, Beckwith BJ, Bugert P, Cooper CS, Delahunt B, Eble JN, Fleming S, Ljungberg B, Medeiros LJ, Moch H, Reuter VE, Ritz E, Roos G, Schmidt D, Srigley JR, Störkel S, van den Berg E, Zbar B (1997) The Heidelberg classification of renal cell tumours. J Pathol 183(2):131–133. doi:10.1002/(SICI)1096-9896(199710)183:2<131::AID-PATH931>3.0.CO;2-G CrossRefPubMed

18.

Algaba F, Trias I, Scarpelli M, Boccon-Gibod L, Kirkali Z, Van Poppel H (2004) Handling and pathology reporting of renal tumor specimens. Eur Urol 45(4):437–443. doi:10.1016/j.eururo.2003.11.026 CrossRefPubMed

19.

Ficarra V, Galfano A, Novara G, Iafrate M, Brunelli M, Secco S, Cavalleri S, Martignoni G, Artibani W (2008) Risk stratification and prognostication of renal cell carcinoma. World J Urol 26(2):115–125. doi:10.1007/s00345-008-0259-y CrossRefPubMed

20.

Golimbu M, Joshi P, Sperber A, Tessler A, Al-Askari S, Morales P (1986) Renal cell carcinoma: survival and prognostic factors. Urology 27(4):291–301. doi:10.1016/0090-4295(86)90300-6 CrossRefPubMed

21.

Terrone C, Cracco C, Guercio S, Bollito E, Poggio M, Scoffone C, Tarabuzzi R, Porpiglia F, Scarpa RM, Fontana D, Rossetti Rocca S (2004) Prognostic value of the invlovement of the urinary collecting system in renal cell carcinoma. Eur Urol 46(4):472–476. doi:10.1016/j.eururo.2004.07.006 CrossRefPubMed

22.

Klatte T, Chung J, Leppert JT, Lam JS, Pantuck AJ, Figlin RA, Belldegrun AS (2007) Prognostic relevance of capsular involvement and collecting system invasion in stage I and II renal cell carcinoma. BJU Int 99(4):821–824. doi:10.1111/j.1464-410X.2006.06729.x CrossRefPubMed

23.

Coons BJ, Stec AA, Stratton KL, Chang SS, Cookson MS, Duke Herrell SD, Smith JA Jr, Clark PE (2009) Prognostic factors in T3b renal cell carcinoma. World J Urol 27(1):75–79. doi:10.1007/s00345-008-0358-9 CrossRefPubMed

24.

Wang F, Gao J (1998) Relationship between extracellular matrix and progressive growth of malignant tumor. Zhonghua Zhong Liu Za Zhi 20(2):112–115PubMed

25.

Kallakury BV, Karikehalli S, Haholu A, Sheehan CE, Azumi N, Ross JS (2001) Increased expression of matrix metalloproteinases 2 and 9 and tissue inhibitors of metalloproteinases 1 and 2 correlate with poor prognostic variables in renal cell carcinoma. Clin Cancer Res 7(10):3113–3119PubMed

26.

Van Poppel H, Vandendriessche H, Boel K, Mertens V, Goethuys H, Haustermans K, Van Damme B, Baert L (1997) Microscopic vascular invasion is the most relevant prognosticator after radical nephrectomy for clinically nonmetastatic renl cell carcinoma. J Urol 158(1):45–49. doi:10.1097/00005392-199707000-00013 CrossRefPubMed

27.

Sorbellini M, Kattan MW, Snyder ME, Reuter V, Motzer R, Goetzl M, McKiernan J, Russo P (2005) A postoperative prognostic nomogram predicting recurrence for patients with conventional clear cell renal cell carcinoma. J Urol 173(1):48–51PubMed

28.

Lang H, Lindner V, Letourneux H, Martin M, Saussine C, Jacqmin D (2004) Prognostic value of microscopic venous invasion in renal cell carcinoma: long-term follow-up. Eur Urol 46(3):331–335. doi:10.1016/j.eururo.2004.03.020 CrossRefPubMed

29.

Blom JH, van Poppel H, Marechal JM, Jacqmin D, Sylvester R, Schröder FH, de Prijck L (1999) Radical nephectomy with and without lymph node dissection: preliminary results of the EORTC randomized phase III protocol 30881. EORTC Genitourinary Group. Eur Urol 36(6):570–575. doi:10.1159/000020050 CrossRefPubMed

Title: Urinary collecting system invasion reflects adverse long-term outcome and is associated with simultaneous metastatic spread at the time of surgery and with multilocular dissemination during postsurgical follow-up in renal cell cancer
Authors: Sabine Brookman-Amissah
Matthias May
Knut Albrecht
Thomas Herrmann
Jan Roigas
Christian Peter Gilfrich
Sandra Pflanz
Sven Gunia
Publication date: 01-02-2010
Publisher: Springer-Verlag
Published in: World Journal of Urology / Issue 1/2010
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-009-0426-9

At a glance: The STEP trials

Springer Medicine

Urinary collecting system invasion reflects adverse long-term outcome and is associated with simultaneous metastatic spread at the time of surgery and with multilocular dissemination during postsurgical follow-up in renal cell cancer

Abstract

Objectives

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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