Journal Mobile Options
Table of Contents
Vol. 36, No. 6, 1999
Issue release date: December 1999
Eur Urol 1999;36:565–569
(DOI:10.1159/000020049)

Prognostic Significance of the Heidelberg Classification of Renal Cell Carcinoma

Ljungberg B. · Alamdari F.I. · Stenling R. · Roos G.
Departments of aUrology and Andrology, and bPathology, Umeå University, Umeå, Sweden

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Objective: The specific genetic alterations characterising renal cell carcinoma (RCC) have lead to the recognition of distinctive types of tumours. In a large material of patients, the prognostic and clinical information of these different tumour types were evaluated. Methods: Tumours from 186 patients were evaluated retrospectively according to the guidelines given by the Heidelberg Classification Conference. All patients were primarily nephrectomised and TNM staged, and the follow-up times for alive patients varied between 44 and 174 months. Results: The material consisted of 145 conventional (non-papillary), 25 papillary, 12 chromophobe and 4 unclassified RCCs. There was no difference in tumour size between the different RCC types. Among patients with conventional RCC, 37% had distant metastases at the time of diagnosis, significantly more frequently than 16% in patients with papillary and 8% in chromophobe RCC (p = 0.044 and 0.048, respectively). Conventional RCC more frequently had vein invasion compared with papillary RCC (p = 0.009). Patients with chromophobe and papillary RCC survived significantly longer than patients with conventional RCC (p = 0.017 and 0.031, respectively). Conclusions: A significant difference in clinical behaviour between the different RCC types was found. Patients with conventional RCC had a higher incidence of metastases, vein invasion and had adverse survival compared with papillary and chromophobe RCCs. Thus, the RCC types recognised by specific genetic alterations seem to represent different malignant phenotypes.

Copyrightz1999S.KargerAG,Basel



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Skinner DG, Colvin RB, Vermillion CD, Pfister RC, Leadbetter WF: Diagnosis and management of renal cell carcinoma. A clinical and pathological study of 309 cases. Cancer 1971;28:1165–1177.
  2. Larsson P, Roos G, Stenling R, Ljungberg B: Tumor cell proliferation and prognosis in renal cell carcinoma. Int J Cancer 1993;55:566–570.
  3. Ljungberg B, Mehle C, Stenling R, Roos G: Heterogeneity in renal cell carcinoma and its impact on prognosis – A flow cytometric study. Br J Cancer 1996;74:123–127.
  4. Thönes W, Störkel S, Rumpelt HJ: 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 1986;181:125–143.
  5. Kovacs G: Application of molecular cytogenetic techniques to the evaluation of renal parenchymal tumors. J Cancer Res Clin Oncol 1990;116:318–322.
  6. Kovacs G: Molecular cytogenetics of renal cell tumors. Adv Cancer Res 1993;62:89–124.
  7. 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, Vandenberg E, Zbar B: The Heidelberg Classification of renal cell tumours. J Pathol 1997;183:131–133.
  8. Crotty TB, Farrow GM, Lieber MM: Chromophobe cell renal carcinoma: Clinicopathological features of 50 cases. J Urol 1995;154:964–967.
  9. Amin MB, Corless CL, Renshaw AA, Tickoo SK, Kubus J, Schultz DS: Papillary (chromophil) renal cell carcinoma: Histomorphologic characteristics and evaluation of conventional pathologic prognostic parameters in 62 cases. Am J Surg Pathol 1997;21:621–635.
  10. Sobin LH, Wittekind Ch (eds): International Union Against Cancer (UICC). TNM Classification of Malignant Tumors, ed 5. New York, Wiley-Liss, 1997, pp 180–182.
  11. Jonas D, Thoma B, Beckert H, Weber W: The value of morphological prognostic criteria in the assessment of renal cell carcinoma. Urol Int 1985;40:148–154.

    External Resources

  12. Kovacs G, Wilkens L, Papp T, de Riese W: Differentiation between papillary and nonpapillary renal cell carcinomas by DNA analysis. J Natl Cancer Inst 1989;81:527–530.
  13. Gnarra JR, Lerman MI, Zbar B, Lineham WM: Genetics of renal-cell carcinoma and evidence for a critical role for von Hippel-Lindau in renal tumorigenesis. Semin Oncol 1995;22: 3–8.
  14. Schullerus D, Herbes J, Chudek J, Kanamaru H, Kovacs G: Loss of heterozygosity at chromosomes 8p, 9p and 14q is associated with stage and grade of nonpapillary renal cell carcinomas. J Pathol 1997;183:151–155.
  15. Kovacs G, Fuzesi L, Emanual A, Kung HF: Cytogenetics of papillary renal cell tumors. Genes Chromosomes Cancer 1991;3:249–255.
  16. Speicher MR, Schoell B, du Manoir S, Schrock E, Ried T, Cremer T, Störkel S, Kovacs A, Kovacs G: Specific loss of chromosomes 1, 2, 6, 10, 13, 17 and 21 in chromophobe renal cell carcinomas revealed by comparative genomic hybridization. Am J Pathol. 1994;145:356–364.
  17. Bugert P, Gaul C, Weber K, Herbers J, Akhtar M, Ljungberg B, Kovacs G: Specific genetic changes of diagnostic importance in chromophobe renal cell carcinomas. Lab Invest 1997;76:203–208.
  18. Akhtar M, Kardar H, Linjawi T, McClintoch J, Ali MA: Chromophobe cell carcinoma of the kidney. A clinicopathologic study of 21 cases. Am J Surg Pathol 1995;19:1245–1256.
  19. Thönes W, Störkel S, Rumpelt HJ, Moll R, Baum HP, Werner S: Chromophobe cell renal carcinoma and its variants – A report on 32 cases. J Pathol 1988;155:277–287.

    External Resources

  20. Mancilla-Jimenez R, Stanley RJ, Blath RA: Papillary renal cell carcinoma: A clinical, radiologic and pathologic study of 34 cases. Cancer 1976;38:2469–2480.
  21. Bard RH, Lord B, Fromowitz F: Papillary adenocarcinoma of kidney. II. Radiographic and biologic characteristics. Urology 1982;19:16–20.

    External Resources

  22. Sene AP, Hunt L, McMahon RF, Carrol RN: Renal carcinoma in patients undergoing nephrectomy: Analysis of survival and prognostic factors. Br J Urol 1992;70:125–134.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50