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Perinephric invasion as a prognostic factor in non-metastatic renal cell carcinoma: analysis of a nation-wide registry program.

Abstract：

OBJECTIVES:Perinephric fat invasion (PFI) of renal cell carcinoma (RCC) is known to be associated with adverse pathological features and poor prognosis. We analyzed these associations using a sub-group of the RCC registry of The Cancer Registration Committee of the Japanese Urological Association. METHODS:The study cohort of 2998 non-metastatic cases was retrieved from RCC registry (3648 in total). We compared clinicopathological characteristics of cases with PFI (n = 256) and without PFI (n = 2742), and investigated the impact of PFI on cancer-specific survival using univariate and multivariate analyses. RESULTS:Compared with non-PFI cases, PFI cases were older (P = 0.003), and more likely to be hypertensive (P = 0.034) and symptomatic at presentation (P < 0.001). PFI tumors were larger (P < 0.001), and more often have sarcomatoid component (P < 0.001) and tumor thrombus (P < 0.001). Cancer-specific survival was significantly shorter in cases with PFI than without (P < 0.001). The difference in survival tended to be greater in cases with large tumors but was significant in small tumor sub-groups. Cancer-specific survival was significantly shorter in cases with both PFI and renal vein involvement (RVI) in comparison to those with PFI or RVI alone (P = 0.011, P = 0.007, respectively). On multivariate analysis PFI with and without sinus fat invasion remained as an independent risk factor along with symptom at presentation, low body mass index, hypertension, multiple tumors, large tumor size (>7.0 cm), sarcomatoid component and RVI. CONCLUSIONS:PFI was associated with advanced age and aggressive pathological features. PFI is an independent prognostic factor in non-metastatic RCC.

journal_name

Jpn J Clin Oncol

journal_title

Japanese journal of clinical oncology

authors

Kume H,Homma Y,Shinohara N,Obara W,Kondo T,Kimura G,Fujimoto H,Nonomura N,Hongo F,Sugiyama T,Takahashi M,Kanayama HO,Fukumori T,Eto M

doi

10.1093/jjco/hyz054

subject

Has Abstract

pub_date

2019-08-01 00:00:00

pages

772-779

issue

eissn

0368-2811

issn

1465-3621

pii

5448906

journal_volume

pub_type

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Perinephric invasion as a prognostic factor in non-metastatic renal cell carcinoma: analysis of a nation-wide registry program.