The Effect of Presence of Satellite Nodules in Nephrectomized Kidney on Survival in Patients with Renal Cell Carcinoma

Lee, Sang Eun; Kim, Dae Young; Son, Hwancheol; Cho, Kyu Sun; Byun, Seok Soo; Park, Moon Soo; Kim, Hyeon Hoe

Abstract

PURPOSE: There are still some debates concerning kidney preserving surgery for ipsilateral renal cell carcinoma and normal contralateral kidney. It has been proposed that about 10 to 20 per cent of the renal cell carcinoma have satellite nodules along with the main tumor mass. But the exact prognostic implication of the satellite nodules has not been clarified yet. In this study, we tried to evaluate whether the presence of the satellite nodules would be an adverse prognostic factor or not after radical nephrectomy.
MATERIALS AND METHODS
From January 1987 until June 1991, 81 patierlts underwent radical nephrectomy, and all of the nephrectomized kidneys were serially cut into slices of 5 mm to probe for any satellite nodules. All the satellite nodults found were examined histologically. All the patients were followed regularly for the mean duration of 67 months.
RESULTS
The patholologic stage of the primary tumor was T1 in 19 patients, T2 in 38, T3 in 22 and T4 in 2 patients. Overall 5 year survival rate was 89.5%. Fifteen patients(18.5%) had satellite nodules with histologically identical patterns to the primary tumor, The presence of the satellite nodules increased according to the increasing tumor stage and the size of the primary tumor mass. The survival rate was significantly decreased with the increasing tumor stage, with the 5 year survival rate of 100% in T1, 96.6% in T2, 71.3% in T3 and none in T4 patients(p=0.0001). But the 5 year survival rate of patients with primary tumor with a diameter of less than 7cm was 96.4% compared to 81.7% who have primary tumor with a diameter 7cm and more(p=0.16). Additionally the presence of the satellite nodules did not have an impact on the survival. The 5 year survival rate was 89.7% in patients without satellite nodules and it was 90% in patients with satellite nodules(p=0.87). CONCLUSIONS: There was significant correlation between pathological stage of the prima tumor and survival rate. However, the presence of the satellite nodule and the primary tumor size did not appear to have an impact on survival. We suggest that the molecular biological study for satellite nodule is needed to characterize the satellite nodule in addition to histopathological study.