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BMC Urology
Published in: BMC Urology 1/2014

Open Access 01-12-2014 | Research article

The impact of tumour size on the probability of synchronous metastasis and survival in renal cell carcinoma patients: a population-based study

Authors: Johann P Ingimarsson, Martin I Sigurdsson, Sverrir Hardarson, Vigdis Petursdottir, Eirikur Jonsson, Gudmundur V Einarsson, Tomas Gudbjartsson

Published in: BMC Urology | Issue 1/2014

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Abstract

Background

The observed low metastatic potential and favorable survival of small incidentally detected renal cell carcinomas (RCCs) have been a part of the rationale for recommending partial nephrectomy as a first treatment option and active surveillance in selected patients. We examined the relationship between tumor size and the odds of synchronous metastases (SMs) (primary outcome) and disease specific survival (secondary outcome) in a nationwide RCC registry.

Methods

Retrospective study of the 794 RCC patients diagnosed in Iceland between 1971 and 2005. Histological material and TNM staging were reviewed centrally. The presence of SM and survival were recorded. Cubic spline analysis was used to assess relationship between tumor size and probability of SM. Univariate and multivariate statistics were used to estimate prognostic factors for SM and survival.

Results

The probability of SM increased in a non-linear fashion with increasing tumor size (11, 25, 35, and 50%) for patients with tumors of ≤4, 4.1-7.0, 7.1-10.0, and >10 cm, respectively. On multivariate analysis, tumor size was an independent prognostic factor for disease-specific survival (HR = 1.05, 95% CI 1.02-1.09, p < 0.001), but not for SM.

Conclusion

Tumor size affected the probability of disease-specific mortality but not SM, after correcting for TNM staging in multivariate analysis. This confirms the prognostic ability of the 2010 TNM staging system for renal cell cancer in the Icelandic population.
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Literature
1.
Gudbjartsson T, Thoroddsen A, Petursdottir V, Hardarson S, Magnusson J, Einarsson G: Effect of incidental detection for survival of patients with renal cell carcinoma: results of population-based study of 701 patients. Urol. 2005, 66: 1186-1191. 10.1016/j.urology.2005.07.009.CrossRefPubMed
2.
Ljungberg B, Cowan N, Hanbury D, Hora M, Kuczyk M, Sinescu I: EAU Guidlines on Renal Cell Carcinoma: The 2010 Update. Eur Urol. 2010, 58: 398-406. 10.1016/j.eururo.2010.06.032.CrossRefPubMed
3.
Campbell S, Novick A, Belldegrun A, Blute M, Chow G, Uzzo R: Guideline for Management of the Clinical T1 Renal Mass. J Urol. 2009, 182: 1271-1279. 10.1016/j.juro.2009.07.004.CrossRefPubMed
4.
Schips L, Lipsky K, Ziegeuner R, Salfellner M, Winkler S, Humber G: Impact of tumor-associated symptoms on the prognosis of patients with renal cell carcinoma: a single-center experience of 683 patients. Urology. 2003, 62: 1024-1028. 10.1016/S0090-4295(03)00763-5.CrossRefPubMed
5.
Cheville J, Blute M, Zincke H, Lohse CM, Weaver A: Stage pT1 conventional (clear cell) renal cell carcinoma: pathological features associated with cancer specific survival. J Urol. 2001, 166: 453-456. 10.1016/S0022-5347(05)65962-9.CrossRefPubMed
6.
Lughezzani G, Jeldres C, Isbarn H, Perrotte P, Shariat S, Karakiewicz P: Tumor Size is a Determinant of the Rate of Stage T1 Renal Cell Cancer Synchronous Metastasis. J Urol. 2009, 182: 1287-1293. 10.1016/j.juro.2009.06.018.CrossRefPubMed
7.
Guðmundsson E, Hellborg H, Lundstam S, Erikson S, Ljungberg B: Metastatic Potential in Renal Cell Carcinomas ≤7 cm: Swedish Kidney Cancer Register Data. Eur Urol. 2011, 60: 975-982. 10.1016/j.eururo.2011.06.029.CrossRefPubMed
8.
Kuczyk M, Wegener G, Merseburger AS, Anastasiadis A, Machtens S, Stenzl A: Impact of tumor size on the long term survival of patients with early stage renal cell cancer. World J Urol. 2005, 23: 50-54. 10.1007/s00345-004-0483-z.CrossRefPubMed
9.
Kunkle D, Crispen P, Li T, Uzzo R: Tumor Size Predicts Synchronous Metastatic Renal Cell Carcinoma: Implications for Surveillance of Small Renal Masses. J Urol. 2007, 177: 1692-1697. 10.1016/j.juro.2007.01.029.CrossRefPubMed
10.
Klatte T, Patard J-J, De Martino M, Bensalah K, Verhoest A, Pantuck : Tumor Size Does Not Predict Risk of Metastatic Disease or Prognosis of Small Renal Cell Carcinomas. J Urol. 2008, 179: 1719-1726. 10.1016/j.juro.2008.01.018.CrossRefPubMed
11.
Klatte T, Patard J-J, Goel R, Kleid M, Guille F, Lam J: Prognostic impact of tumor size on pT2 renal cell carcinoma: an international multicenter experience. J Urol. 2007, 178: 35-40. 10.1016/j.juro.2007.03.046.CrossRefPubMed
12.
Ficarra V, Prayer-Galetti T, Novara G, Bratti E, Zanolla L: Tumor-size breakpoint for prognostic stratification of localized renal cell carcinoma. Urology. 2004, 63: 235-240. 10.1016/j.urology.2003.09.081.CrossRefPubMed
13.
Waalkes S, Becker F, Schrader A, Janssen M, Wegener G, Kuczyk M: Is There a Need to Further Subclassify pT2 Renal Cell Cancers as Implemented by the Revised 7th TNM Version?. Eur Urol. 2001, 59: 258-263.CrossRef
14.
Brookman-May S, May M, Ziegeuner R, Shariat SF, Scherr DS, Pahernik S: Collecting System Invasion and Fuhrman Grade But Not Tumor Size Facilitate Prognostic Stratification of Patients With pT2 Renal cell Carcinoma. J Urol. 2011, 186: 2175-2181. 10.1016/j.juro.2011.07.105.CrossRefPubMed
15.
Nguyen M, Gill I: Effect of REnal Cancer Size on the Prevanlence of Metastasis at Diagnosis and Mortality. J Urol. 2009, 181: 1020-1027. 10.1016/j.juro.2008.11.023.CrossRefPubMed
16.
Kates M, Korets R, Sadeghi N, Pierorazio P, McKiernan J: Predictors of locally advanced and metastatic disease in patients with small renal masses. BJU Int. 2012, 109: 1463-1467. 10.1111/j.1464-410X.2011.10553.x.CrossRefPubMed
17.
Elbe J, Sauter G, Epstein J: World Health Organization International Classification of Tumours. Tumours of the Urinary Systmen and Male Genitla Organs. 2004, Lyons: IARC Press
18.
Greene F, Page D, Fleming ID: American Joint Committee on Cancer Staging Manual. 2002, New York: Springer-VerlagCrossRef
19.
Pahernik S, Ziegler S, Roos F, Melchior S, Thuroff J: Small Renal Tumors: Correlation of Clinical and Pathological Features With Tumor Size. J Urol. 2007, 178: 414-147. 10.1016/j.juro.2007.03.129.CrossRefPubMed
20.
Thompson RH, Hill J, Babayev Y, Cronin A, Kaag M, Russo P: Metastatic Renal Cell Carcinoma Risk According to Size. J Urol. 2009, 182: 41-45. 10.1016/j.juro.2009.02.128.CrossRefPubMedPubMedCentral
21.
Kume H, Suzuki M, Fujimura T, Fukuhara H, Enomoto Y, Homma Y: Distant Metastasis of Renal Cell Carcinoma With a Diameter of 3 cm or less - Which is Agressive Cancer. J Urol. 2010, 184: 64-68. 10.1016/j.juro.2010.03.019.CrossRefPubMed
22.
Yoo C, Song C, Hong JH, Kim C-S, Ahn H: Prognostic Significance of Perinephric Fat Infilitrtion and TUmor Size in Ranal Cell Carcinoma. J Urol. 2008, 180: 486-491. 10.1016/j.juro.2008.04.034.CrossRefPubMed
23.
Hutterer G, Patard J-J, Jeldres C, Perrotte P, De La Taille A, Karakiewicz P: Patients with distant metastase from renal cell carcinoma can be accurately identified: external validation of a new nomogram. BJU Int. 2008, 101: 39-43. 10.1111/j.1464-410X.2008.07648.x.CrossRefPubMed
24.
Karakiewicz P, Lewinstein D, Chun F, Briganti A, Guille F, Patard J-J: Tumor Size Improves the Accuracy of TNM Predictions in Patients with Renal Cancer. Eur Urol. 2006, 50: 521-529. 10.1016/j.eururo.2006.02.034.CrossRefPubMed
Metadata
Title
The impact of tumour size on the probability of synchronous metastasis and survival in renal cell carcinoma patients: a population-based study
Authors
Johann P Ingimarsson
Martin I Sigurdsson
Sverrir Hardarson
Vigdis Petursdottir
Eirikur Jonsson
Gudmundur V Einarsson
Tomas Gudbjartsson
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Urology / Issue 1/2014
Electronic ISSN: 1471-2490
DOI
https://doi.org/10.1186/1471-2490-14-72

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