Microscopic Vascular Invasion is the Most Relevant Prognosticator After Radical Nephrectomy for Clinically Nonmetastatic Renal Cell Carcinoma

Abstract

No AccessJournal of UrologyClinical Urology: Original Article1 Jul 1997Microscopic Vascular Invasion is the Most Relevant Prognosticator After Radical Nephrectomy for Clinically Nonmetastatic Renal Cell Carcinoma Hein Van Poppel, Hans Vandendriessche, Kristien Boel, Veerle Mertens, Hans Goethuys, Karin Haustermans, Boudewijn Van Damme, and Luc Baert Hein Van PoppelHein Van Poppel More articles by this author , Hans VandendriesscheHans Vandendriessche More articles by this author , Kristien BoelKristien Boel More articles by this author , Veerle MertensVeerle Mertens More articles by this author , Hans GoethuysHans Goethuys More articles by this author , Karin HaustermansKarin Haustermans More articles by this author , Boudewijn Van DammeBoudewijn Van Damme More articles by this author , and Luc BaertLuc Baert More articles by this author View All Author Informationhttps://doi.org/10.1097/00005392-199707000-00013AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Although many factors have been considered to predict the outcome after radical nephrectomy, renal cell carcinoma continues to behave unpredictably. In a retrospective study the correlation between microvascular tumor invasion and disease-free survival after surgery for renal cell carcinoma was analyzed. Materials and Methods: Between 1980 and 1993, 180 patients (mean age 60 years) were followed for a mean of 52 months after radical or partial nephrectomy for clinically localized renal cell carcinoma. The relevance of microscopic vascular invasion was compared to classical tumor staging, grade and tumor diameter. Results: Microscopic vascular invasion was found in 51 patients (28.3%), including 20 (39.2%) with progression (mean interval to progression 72 months). Of 129 patients with no pathological evidence of microscopic vascular invasion only 8 (6.2%) showed progression at a mean interval of more than 160 months. The difference in disease-free survival as a function of microvascular invasion was statistically highly significant (log rank p <0.00001) and on multivariate analysis this parameter was by far the most relevant predictor of progression. Conclusions: In patients who underwent radical nephrectomy for clinically nonmetastatic renal cell carcinoma with microvascular invasion but without lymph node involvement or macroscopic vascular invasion the chance of disease progression is estimated at 45% within 1 year. Microvascular invasion is the single most relevant prognosticator after presumed curative radical nephrectomy for renal cell carcinoma. References 1 : Diagnosis and management of renal cell carcinoma: a clinical and pathologic study of 309 cases.. Cancer1971; 28: 1165. Google Scholar 2 : Surgical management and prognosis of renal cell carcinoma invading the vena cava.. J. Urol.1991; 145: 20. 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Abstract, Google Scholar From the Departments of Urology, Pathology and Radiotherapy, University Hospitals of the Katholieke Universiteit Leuven, Leuven, Belgium.© 1997 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byEisenberg M, Cheville J, Thompson R, Kaushik D, Lohse C, Boorjian S, Costello B and Leibovich B (2018) Association of Microvascular and Capillary-Lymphatic Invasion with Outcome in Patients with Renal Cell CarcinomaJournal of Urology, VOL. 190, NO. 1, (37-43), Online publication date: 1-Jul-2013.Kroeger N, Rampersaud E, Patard J, Klatte T, Birkhäuser F, Shariat S, Lang H, Rioux-Leclerq N, Remzi M, Zomorodian N, Kabbinavar F, Belldegrun A and Pantuck A (2018) Prognostic Value of Microvascular Invasion in Predicting the Cancer Specific Survival and Risk of Metastatic Disease in Renal Cell Carcinoma: A Multicenter InvestigationJournal of Urology, VOL. 187, NO. 2, (418-423), Online publication date: 1-Feb-2012.Dall’Oglio M, Arap M, Antunes A, Cury J, Leite K and Srougi M (2018) Impact of Clinicopathological Parameters in Patients Treated for Renal Cell CarcinomaJournal of Urology, VOL. 177, NO. 5, (1687-1691), Online publication date: 1-May-2007.Dall’Oglio M, Ribeiro-Filho L, Antunes A, Crippa A, Nesrallah L, Gonçalves P, Leite K and Srougi M (2018) Microvascular Tumor Invasion, Tumor Size and Fuhrman Grade: A Pathological Triad for Prognostic Evaluation of Renal Cell CarcinomaJournal of Urology, VOL. 178, NO. 2, (425-428), Online publication date: 1-Aug-2007.Gonçalves P, Srougi M, Dall’Oglio M, Leite K, Ortiz V and Hering F (2018) RE: LOW CLINICAL STAGE RENAL CELL CARCINOMA: RELEVANCE OF MICROVASCULAR TUMOR INVASION AS A PROGNOSTIC PARAMETERJournal of Urology, VOL. 173, NO. 3, (1046-1046), Online publication date: 1-Mar-2005.GONÇALVES P, SROUGI M, DALL’OGLIO M, LEITE K, ORTIZ V and HERING F (2018) LOW CLINICAL STAGE RENAL CELL CARCINOMA: RELEVANCE OF MICROVASCULAR TUMOR INVASION AS A PROGNOSTIC PARAMETERJournal of Urology, VOL. 172, NO. 2, (470-474), Online publication date: 1-Aug-2004.DRACHENBERG D, MENA O, CHOYKE P, LINEHAN W and WALTHER M (2018) PARENCHYMAL SPARING SURGERY FOR CENTRAL RENAL TUMORS IN PATIENTS WITH HEREDITARY RENAL CANCERSJournal of Urology, VOL. 172, NO. 1, (49-53), Online publication date: 1-Jul-2004. Volume 158Issue 1July 1997Page: 45-49 Advertisement Copyright & Permissions© 1997 by American Urological Association, Inc.MetricsAuthor Information Hein Van Poppel More articles by this author Hans Vandendriessche More articles by this author Kristien Boel More articles by this author Veerle Mertens More articles by this author Hans Goethuys More articles by this author Karin Haustermans More articles by this author Boudewijn Van Damme More articles by this author Luc Baert More articles by this author Expand All Advertisement PDF downloadLoading ...