Oncological outcomes of patients with incidental pathological T3a stage small renal cell carcinoma after partial nephrectomy

Area of Science:

• Urology
• Oncology
• Nephrology

Background:

• Small renal cell carcinomas (RCCs) are often treated with partial nephrectomy (PN).
• Understanding oncological outcomes based on pathological T stage is crucial for treatment planning.
• Incidental pathological T3a (pT3a) lesions in small RCCs require evaluation compared to pT1a lesions.

Purpose of the Study:

• To compare oncological outcomes of patients with pathological T1a (pT1a) small renal cell carcinomas (RCCs) versus incidental pathological T3a (pT3a) RCCs treated with partial nephrectomy (PN).

Main Methods:

• Retrospective evaluation of 1367 patients undergoing PN for small RCCs (≤4 cm) between 1997 and 2014.
• Kaplan-Meier method used for recurrence-free, cancer-specific, and overall survival estimation.
• Cox regression analysis applied to determine prognostic significance of variables.

Main Results:

• Out of 1367 patients, 1324 (96.8%) had pT1a and 43 (3.2%) had pT3a lesions.
• 5- and 10-year recurrence-free survival rates were comparable: 98.0% vs 94.4% (pT1a) and 95.2% vs 95.2% (pT3a).
• Multivariate analysis indicated tumor size as a significant predictor for recurrence-free and cancer-specific survival, but pT stage (pT3a vs. pT1a) was not significant for RFS, CSS, or OS.

Conclusions:

• Pathological T3a stage disease in small RCCs treated with PN demonstrates similar oncological outcomes to pT1a stage disease.
• These findings suggest that pT stage may not be as critical as tumor size in predicting outcomes for small RCCs treated with PN.