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KMID : 0311120080490040639
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Yonsei Medical Journal
2008 Volume.49 No. 4 p.639 ~ p.646
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A Multi-institutional Study on Histopathological Characteristics of Surgically Treated Renal Tumors: the Importance of Tumor Size
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Kim Sun-Il
Cho In-Rae
Kim Hong-Sup
Song Ki-Hak
Kim Chun-Il
Hong Sung-Joon
Chung Byung-Ha
Kim Se-Joong
Song Yun-Seob
Yang Won-Jae
Kim Young-Sig
Cho Jin-Seon
Cheon Sang-Hyeon
Seong Do-Hwan
Choi Yeung-Deuk
Lee Dong-Hyeon
Lee Joong-Shik
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Abstract
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Purpose: The incidence of accidentally detected small renal tumors is increasing throughout the world. In this multi-institutional study performed in Korea, histopathological characteristics of contemporarily surgically removed renal tumors were reviewed with emphasis on tumor size.
Materials and Methods: Between January 1995 and May 2005, 1,702 patients with a mean age of 55 years underwent surgical treatment at 14 training hospitals in Korea for radiologically suspected malignant renal tumors. Clinicopathological factors and patient survival were analyzed.
Results: Of the 1,702 tumors, 91.7% were malignant and 8.3% were benign. The percentage of benign tumors was significantly greater among those ≤ 4cm (13.2%) than those > 4cm (4.5%) (p < 0.001). Among renal cell carcinoma patients, the percentage of tumors classed as stage ≥ T3 was significantly less among tumors ≤ 4cm (5.2%) than those > 4cm (26.8%) (p < 0.001). The percentage of tumors classed as Fuhrman’s nuclear grades ≥ 3 was also significantly less among tumors ≤ 4cm (27.3%) than tumors > 4cm (50.9%) (p < 0.001). The 5-year cancer-specific survival rate was 82.7%, and T stage (p < 0.001), N stage (p < 0.001), M stage (p = 0.025), and Fuhrman’s nuclear (p < 0.001) grade were the only independent predictors of cancer-specific survival.
Conclusion: In renal tumors, small tumor size is prognostic for favorable postsurgical histopathologies such as benign tumors, low T stages, and low Fuhrman’s nuclear grades. Our observations are expected to facilitate urologists to adopt function-preserving approach in the planning of surgery for small renal tumors with favorable predicted outcomes.
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KEYWORD
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Kidney neoplasms, renal cell carcinoma, nephrectomy, surgical pathology
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