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KMID : 0358320090500020105
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Korean Journal of Urology
2009 Volume.50 No. 2 p.105 ~ p.110
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Prognostic Impact of pT3a Components (Perirenal Fat or Adrenal Gland Involvement) in Patients with pT3b Renal Cell Carcinoma
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Lee Dong-Woo
Kwon Tae-Gyun
Yoo Eun-Sang
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Abstract
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Purpose: To analyze the prognostic impact of the pT3a components, perirenal fat or adrenal gland involvement, in patients with pT3b renal cell carcinoma (RCC).
Materials and Methods: Between January 1997 and June 2006, a total of 36 patients with pT3b RCC who underwent radical nephrectomy with complete resection of the tumor thrombus were included. The presence of pT3a components was reviewed retrospectively, and disease-specific survival was compared between the pT3b only group and the pT3b with pT3a group by the Kaplan-Meier method. To evaluate the prognostic impact of the pure pT3a and pT3b components, we also compared these results with those of pT3aN0M0 only patients (n=44).
Results: After a thorough review by a pathologist, 21 patients were identified as having pT3b only and 15 patients as having pT3b+pT3a. The mean disease-specific survival time in those with pT3b only was significantly longer at 42±7 (SE) months compared with 18±4 (SE) months in those with pT3b+pT3a. The mean disease-specific survival time in those with pT3aN0M0 was significantly longer than in the pT3bN0M0 group and pT3b+pT3aN0M0 group. In multivariate analyses by use of the Cox-proportional hazard model, the presence of pT3a components (p=0.032), preoperative metastasis (p=0.001), and preoperative ECOG performance status (p=0.001) were recognized as predictors of a poor prognosis.
Conclusions: In patients with pT3b RCC, the presence of pT3a components might be indicative of significantly poor prognosis. Careful preoperative and postoperative evaluation should be performed, and pT3b RCC should be reclassified according to the presence of pT3a components. (Korean J Urol 2009;50:105-110)
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KEYWORD
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Renal cell carcinoma, Thrombosis, Fats, Adrenal glands, Prognosis
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