Korean J Urol.  2006 Jun;47(6):601-606. 10.4111/kju.2006.47.6.601.

Optimal Size Cutoff Point for Prognostic Stratification of Localized Renal Cell Carcinoma

• Lee DG
• Chang SG
• Jeon SH

• KMID: 2294233
• DOI: http://doi.org/10.4111/kju.2006.47.6.601

Abstract

PURPOSE: The purpose of this study was to evaluate the validity of the cutoff size for a localized renal cell carcinoma (RCC) by assessing the survival of RCC patients according to a series of alternative size cutoff values.
MATERIALS AND METHODS
The outcomes of 147 patients with localized RCC, treated by radical nephrectomy at our institution, between 1984 and 2004, were retrospectively evaluated. The mean follow-up period was 54.9+/-32.5 months. The survival of patients with tumors smaller than a specified size cutoff was compared with that of tumors larger than the cutoff, and the most discriminating cutoff identified.
RESULTS
114 and 33 patients were pT1 (77.6%) and pT2 (22.4%), respectively. There were 10 recurrences (8.8%) and 6 deaths (5.3%) in the pT1 group, and 8 recurrences (24.2%) and 8 deaths (24.2%) in the pT2 group. The differences in survival were maximized when the tumor size cutoff point was 7cm (cancer-specific survival rate: 92.0% vs. 71.5% p=0.0003, diseasefree survival rate: 88.5% vs. 69.1% p=0.0092). The next significant difference was observed with a cutoff of 4cm (cancer-specific survival rate: 96.0% vs. 83.7% p=0.0467, disease-free survival rate: 96.0% vs. 78.8% p=0.0121).
CONCLUSIONS
Tumor size is an important prognostic factor in patients with an organ confined RCC. The established cutoff point of 7cm provided reasonable prognostic differences. A 4cm cutoff point is also feasible for separating groups with different survivals after a nephrectomy. Hence, the T1a/1b/T2 classification system is practical for the division of localized RCC.

Keyword

Renal cell carcinoma; Neoplasm staging; Neoplasms

MeSH Terms

Carcinoma, Renal Cell*
Classification
Disease-Free Survival
Follow-Up Studies
Humans
Neoplasm Staging
Nephrectomy
Recurrence
Retrospective Studies
Survival Rate

Figure

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  Fig. 1. Cancer-specific survival curves and 5 year survival rates (5YRS).

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