[Pathological prognostic indicators in renal cell carcinoma].

Area of Science:

• Oncology
• Pathology
• Surgical Oncology

Context:

• Renal cell carcinoma (RCC) prognosis traditionally relies on TNM staging, Fuhrman grade, and tumor size.
• Histological factors like tumor necrosis, microscopic vascular invasion, and sinus fat invasion are not routinely assessed.
• Understanding these factors can refine prognostic accuracy for localized RCC.

Purpose:

• To evaluate the prognostic significance of non-traditional histological factors in localized renal cell carcinoma.
• To compare the impact of tumor necrosis, vascular invasion, and sinus fat invasion against established prognostic indicators.
• To determine the most influential factors for cancer-specific and disease-free survival in RCC patients.

Summary:

• A retrospective analysis of 139 localized RCC patients undergoing nephrectomy was performed.
• Univariate analysis showed all assessed variables significantly influenced RCC mortality.
• Multivariate analysis identified Fuhrman grade as the strongest predictor of survival, while pT stage and Fuhrman grade significantly impacted disease-free survival.

Impact:

• Fuhrman grade and pT stage are confirmed as critical prognostic factors for localized RCC survival and disease-free survival.
• Tumor necrosis, microscopic vascular invasion, and sinus fat invasion are identified as significant prognostic indicators for RCC-related death.
• These findings can potentially enhance risk stratification and treatment planning for renal cell carcinoma patients.