Microscopic Vascular Invasion as Prognostic Factor for Renal Cell Carcinoma

Kim, Sang Jin; Yoon, Jong Min; Jeon, Seong Soo; Park, Cheol Keun; Chai, Soo Eung; Choi, Han Yong

Abstract

PURPOSE: It has been reported that renal cell carcinoma patients with microscopic vascular invasion showed poor treatment outcome. We analysed the association between microscopic vascular invasion and other variable pathologic and clinical parameters, which are known as poor prognostic factors, to evaluate the significance of microscopic vascular invasion as a prognostic factor.
MATERIALS AND METHODS
157 patients (108 men and 49 women, mean age 53 years) who had received radical nephrectomy (153 patients) or partial nephrectomy (4 patients) for the treatment of renal cell carcinoma were evaluated. Microscopic vascular invasion was compared with Fuhrman's nuclear grade, TNM stage, tumor diameter, lymph node involvement, p53 point mutation, result of flow cytometry, and recurrence.
RESULTS
Microscopic vascular invasion was found in 51 of 157 patients (32.5%). Microscopic vascular invasion showed significant relationship with Fuhrman's nuclear grade, T stage, and tumor diameter (p<0.05). Microscopic vascular invasion was observed more frequently in patients with lymph node involvement, DNA aneupolid tumor, and recurrence (p<0.05).
CONCLUSIONS
Microscopic vascular invasion was related to higher T stage, higher grade, larger tumor diameter, lymph node involvement, DNA aneuploid tumor, and recurrence. Microscopic vascular invasion might be another important finding to predict prognosis not to be overlooked. And since there is a higher possibility of lymph node metastasis and tumor recurrence in cases with microscopic vascular invasion, localized renal cell carcinoma patients with microscopic vascular invasion should be followed closely for metastatic disease.