Multifocality Incidence and Accompanying Clinicopathological Factors in Renal Cell CarcinomaSargin S.Y. · Ekmekcioglu O. · Arpali E. · Altinel M. · Voyvoda B.
Department of Urology, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey
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Introduction: The incidence of multifocality and associated clinicopathological factors in renal cell carcinoma were evaluated. Materials and Methods: Clinicopathological characteristics were assessed for 122 renal cell carcinoma-pathological specimens from 121 patients. Microscopic and gross tumor pathology, incidence of multifocality as well as association between tumor grade, histological subtype, stage, size and vascular involvement were assessed. Results: Multifocal renal cell carcinoma was diagnosed in 16 of 122 specimens (13.1%). Satellite lesions for 15 of 16 specimens displaying mulifocality had the same histological subtype as their primary tumor. The occult multifocality rate was 11.4%. Tumor grade and stage, but not size or volume, histological subtype, and vascular involvement were significantly related to multifocality. Conclusions: Accurate staging of renal cell carcinoma appears to be essential in determining whether a patient should undergo nephron-sparing surgery or radical nephrectomy. Patients with high stage and grade should receive the highest attention after nephron-sparing surgery. Larger studies are needed to further elucidate the association between clinicopathological factors and multifocality.
© 2009 S. Karger AG, Basel
- Whang M, O’Toole K, Bixon R, Brunetti J, Ikeguchi E, Olsson CA, Sawczuk TS, Benson MC: The incidence of multifocal renal cell carcinoma in patients who are candidates for partial nephrectomy. J Urol 1995;154:968–971.
- Gohji K, Hara I, Gotoh A, Eto H, Miyake H, Sugiyama T, Okada H, Arakawa S, Kamidono S: Multifocal renal cell carcinoma in Japanese patients with tumors with maximal diameters of 50 mm or less. J Urol 1998;159:1144–1147.
- Kletscher BA, Qian J, Bostwick DG, Andrews PE, Zincke H: Prospective analysis of multifocality in renal cell carcinoma: influence of histological pattern, grade, number, size, volume and deoxyribonucleic acid ploidy. J Urol 1995;153:904–906.
- Baltacı S, Orhan D, Soyupek S, Bedük Y, Tulunay O, Göğüş O: Influence of tumor stage, size, grade, vascular involvement, histological cell type and histological pattern on multifocality of renal cell carcinoma. J Urol 2000;164:36–39.
- Richstone L, Scherr DS, Reuter VR, Snyder ME, Rabbani F, Kattan MW, Russo P: Multifocal renal cortical tumors: frequency, associated clinicopathological features and impact on survival. J Urol 2004;171:615–620.
- Melissourgos N, Doumas K, Messim I, Papaliodi E, Kastrinakis NG, Lykourinas M: Multicentricity in renal cell carcinoma: can primary tumor location serve as a co-determinant of surgical treatment? Eur Urol 2002;41:262–266.
- Li QL, Guan HW, Zhang QP, Xue J, Wang FP, Song XS: Multifocality and its associated factors in renal cell carcinoma. Chin Med J 2002;115:1341–1344.
- Di Marco DS, Lohse CM, Zinche H, Cheville JC, Blute ML: Long-term survival of patients with unilateral sporadic multifocal renal cell carcinoma according to histologic subtype compared with patients with solitary tumors after radical nephrectomy. Urology 2004;64:462–467.
- Fuhrman SA, Lasky LC, Limas C: Prognostic significance of morphologic parameters in renal cell carcinoma. Am J Surg Pathol 1982;6:655–663.
- Störkel S, Eble JN, Adlakha K, Amin M, Blute ML, Bostwick DG, Darson M, Delahunt B, Iczkowski K: Classification of renal cell carcinoma. Cancer 1997;80:987–989.
Sobin LH, Wittekind C: TNM Classification of Malignant Tumors, ed 6. New York, Wiley-Liss, 2002, p 239.
- Karayiannis A, Varkarakis I, Chort M, Alivizatos G, Fragiskos S: Multifocality of renal cell tumors is a factor to consider before performing a partial nephrectomy. Anticancer Res 2002;22:3103–3107.
- Lang H, Lindner V, Martin M, Letourneux H, Roy C, Saussine C, Jacqmin D: Prognostic value of multifocality on progression and survival in localized renal cell carcinoma. Eur Urol 2004;45:749–753.
- Oya M, Nakamura K, Baba S, Hata JI, Tazaki H: Intrarenal satellites of renal cell carcinoma: histopathologic manifestation and clinical implication. Urology 1995;46:161–164.
- Kinouchi T, Mano M, Saiki S, Meguro N, Maeda O, Kuroda M, Usami M, Kotake T: Incidence rate of satellite tumors in renal cell carcinoma. Cancer 1999;86:2331–2336.
- Mejean A, Hopirtean V, Bazin JP, Larousserie F, Benoit H, Chretien Y, Thiounn N, Dufour B: Prognostic factors for the survival of patients with papillary renal cell carcinoma: meaning of histological typing and multifocality. J Urol 2003;170:764–767.
- Uzzo RG, Novick AC: Nephron sparing surgery for renal tumors: indications, techniques and outcomes. J Urol 2001;166:6–18.
- Bilen CY, Mahalati K, Ozen H, Aki TF, Ilyas C, Kendi S: Multicentricity in renal cell carcinoma. Int Urol Nephrol 1999;31:295–299.
- Schlichter A, Schubert R, Werner W, Zermann DH, Schubert J: How accurate is diagnostic imaging in determination of size and multifocality of renal cell carcinoma as a prerequisite for nephron sparing surgery? Urol Int 2000;64:192–197.
- Kopka L, Fischer U, Zoeller G, Schmidt C, Ringert RH, Grabbe E: Dual-phase helical CT of the kidney: value of the corticomedullary and nephrographic phase for evaluation of renal lesions and preoperative staging of renal cell carcinoma. Am J Roentgenol 1997;169:1573–1578.
- Huang JG, Israel G, Berman A, Taneja SS: Preoperative renal tumor evaluation by three-dimensional magnetic resonance imaging: staging and detection of multifocality. Urology 2004;64:453–457.
- Remzi M, Özsoy M, Klingler HC, Susani M, Waldert M, Seitz C, Schmidbauer J, Marberger M: Are small renal tumors harmless? Analysis of histopathological features according to tumors 4 cm or less in diameter. J Urol 2006;176:896–899.
- Wunderlich H, Schlichter A, Zermann DH, Reichelt O, Kosmehl H, Schubert J: Multifocality in renal cell carcinoma: a bilateral event? Urol Int 1999;63:160–163.
- Wunderlich H, Reichelt O, Schuman S, Schlichter A, Kosmehl H, Wener W, Vollandt R, Schubert J: Nephron sparing surgery for renal cell carcinoma 4 cm or less in diameter: indicated or under treated? J Urol 1998;159:1465–1469.
- Lerner SE, Hawkins CA, Blute ML, Grabner A, Wollan PC, Eickholt JT, Zincke H: Disease outcome in patients with low stage renal cell carcinoma treated with nephron sparing or radical surgery. J Urol 1996;155:1868–1873.
- Hafez KS, Fergany AF, Novick AC: Nephron sparing surgery for localized renal cell carcinoma: impact of tumor size on patient survival, tumor recurrence and TNM staging. J Urol 1999;162:1930–1933.
- Fergany AF, Hafez KS, Novick AC: Long-term results of nephron sparing surgery for localized renal cell carcinoma: 10-year followup. J Urol 2000;163:442–445.
- Cheville JC, Lohse CM, Zincke H, Weaver AL, Blute ML: Comparisons of outcome and prognostic features among histologic subtypes of renal cell carcinoma. Am J Surg Pathol 2003;27:612–624.
- Ghavamian R, Cheville JC, Lohse CM, Weaver AL, Zincke H, Blute ML: Renal cell carcinoma in the solitary kidney: an analysis of complications and outcome after nephron sparing surgery. J Urol 2002;168:454–459.
Ljungberg B, Hanbury DC, Kuczyk MA, Merseburger AS, Mulders PFA, Patard JJ, Sinescu IC: Guidelines on Renal Cell Carcinoma. Arnhem, European Association of Urology, 2007, pp 4–13.
- Lee CT, Katz J, Shi W, Thaler HT, Reuter VE, Russo P: Surgical management of renal tumors 4 cm or less in a contemporary cohort. J Urol 2000;163:730–736.
- Blute ML, Thibault GP, Leibovich BC, Cheville JC, Lohse CM, Zincke H: Multiple ipsilateral renal tumors discovered at planned nephron sparing surgery: importance of tumor histology and risk of metachronous recurrence. J Urol 2003;170:760–763.
- Barbalias GA, Liatsikos EN, Tsintavis A, Nikiforidis G: Adenocarcinoma of the kidney: nephron sparing surgical approach vs. radical nephrectomy. J Surg Oncol 1999;72:156–161.
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