Parameters predictive of multicentricity in renal cell carcinoma

Over a 3-year period, 83 radical nephrectomies were performed for renal cell carcinoma. The preoperative radiologic investigations and pathology were reviewed. The incidence of multicentricity of the tumors was correlated with various clinical and pathologic parameters. These included polar location, histologic type, histologic grade (divided into low: Fuhrman grade 1 to 2; and high: Fuhrman grade 3 to 4), size on pathology, pathologic stage, capsular invasion, microscopic vascular invasion, renal vein or inferior vena cava (IVC) involvement, collecting system involvement, lymph node metastases and adrenal gland metastases. The incidence of multicentricity was 9/83 (11%). On univariate analysis, no factors were predictive of multicentricity. On logistic regression analysis, microscopic vascular invasion (p=0.021) and tubulo-papillary histology (p=0.049) were the only significant independent predictors of multicentricity. A model incorporating these parameters missed all multicentric tumors.