Assessment of stage T1 (TNM 1997) for renal cell carcinoma: is recommended the subdivision in T1a and T1b?

Assessment of stage T1 (TNM 1997) for renal cell carcinoma: is recommended the subdivision in T1a and T1b?

Author Dall Oglio, Marcos Francisco Autor UNIFESP Google Scholar
Srougi, Miguel Autor UNIFESP Google Scholar
Mangini, Marcelo Google Scholar
Ribeiro, Eduardo Autor UNIFESP Google Scholar
Ferraz, Márcio Autor UNIFESP Google Scholar
Sañudo, Adriana Autor UNIFESP Google Scholar
Leite, Kátia Ramos Moreira Autor UNIFESP Google Scholar
Nesrallah, Luciano Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract INTRODUCTION: Classification TNM 1997 defines renal cell carcinoma smaller than 7 cm and confined to the kidney as stage T1. Our goal is to discuss if tumors smaller than 4 cm have the same behavior characteristics then tumors between 4 and 7 cm, to compose the same stage of the disease. MATERIALS AND METHODS: Retrospective assessment of 138 patients in stage T1 (TNM - 97), divided into 2 groups; group-1: composed of 65 patients (47%) with tumors < 4 cm, and group-2: composed of 73 patients (53%) with tumors between 4 and 7 cm. The following prognostic factors were assessed in the recurrence of the disease and survival of patients: nuclear degree, microvascular invasion, sarcomatous degeneration, and involved lymph nodes. Statistical evaluation has been accomplished through the log rank test, chi-square test, and Fishers exact text. RESULTS: Average tumor size was 2.5 cm for group-1, and 5.3 cm for group-2. In group-2, there was the predominance of worse prognostic factors, with high-grade tumors (p = 0.01) and presence of microvascular invasion (p = 0.001). Sarcomatous tumors and involvement of lymph nodes did only happen in group-2. Disease-free survival for group-1, analyzed in the median period of 36 months, was 100%, and for group 2, in the median period of 31 months, was 81% (p = 0.008). CONCLUSION: The results obtained allow the conclusion that the present stage T1 for renal cell carcinoma gathers tumors of different evolution, being therefore recommendable the stratification in T1a for tumors smaller than 4 cm, and T1b for tumors between 4 and 7 cm.
Keywords kidney
carcinoma
renal cell
neoplasm staging
prognosis
classification
survival
Language English
Date 2003-04-01
Published in International braz j urol. Sociedade Brasileira de Urologia, v. 29, n. 2, p. 106-112, 2003.
ISSN 1677-5538 (Sherpa/Romeo)
Publisher Sociedade Brasileira de Urologia
Extent 106-112
Origin http://dx.doi.org/10.1590/S1677-55382003000200003
Access rights Open access Open Access
Type Article
SciELO ID S1677-55382003000200003 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/1681

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