Yonsei Med J.  2008 Aug;49(4):639-646. 10.3349/ymj.2008.49.4.639.

A Multi-institutional Study on Histopathological Characteristics of Surgically Treated Renal Tumors: the Importance of Tumor Size

• Kim SI
• Choi YD
• Kim SJ
• Chung BH
• Seong DH
• Kim CI
• Cheon SH
• Cho JS
• Song YS
• Kim YS
• Cho IR
• Lee DH
• Song KH
• Kim HS
• Lee JS
• Yang WJ
• Hong SJ

• KMID: 1793201
• DOI: http://doi.org/10.3349/ymj.2008.49.4.639

Abstract

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 < or = 4cm (13.2%) than those > 4cm (4.5%) (p < 0.001). Among renal cell carcinoma patients, the percentage of tumors classed as stage > or = T3 was significantly less among tumors < or = 4cm (5.2%) than those > 4cm (26.8%) (p < 0.001). The percentage of tumors classed as Fuhrman's nuclear grades > or = 3 was also significantly less among tumors < or = 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.

Keyword

Kidney neoplasms; renal cell carcinoma; nephrectomy; surgical pathology

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Female
Humans
Kidney Neoplasms/classification/*pathology/*surgery
Male
Middle Aged
Neoplasm Staging

Figure

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  Fig. 1 Cancer-specific survival curve of 1,290 patients who underwent radical or nephron-sparing surgery for renal cell carcinoma.

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