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Updated: Feb 5, 2026
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A Mouse 5/6th Nephrectomy Model That Induces Experimental Uremic Cardiomyopathy
Published on: November 7, 2017
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Risk factors and prognostic implications for pathologic upstaging to T3a after partial nephrectomy
Alp T Beksac1, David J Paulucci1, Zeynep Gul1
1Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Summary
Older age and larger tumor size increase the risk of pathological T3a upstaging in clinical T1 kidney tumors treated with partial nephrectomy. This upstaging is linked to positive surgical margins and potentially impacts overall survival.
Area of Science:
- Urology
- Oncology
- Pathology
Background:
- Partial nephrectomy (PN) for clinical T1 (cT1) renal tumors may lead to pathological T3a (pT3a) upstaging.
- Upstaging can potentially compromise cancer-specific survival.
- Identifying risk factors for pT3a upstaging is crucial.
Purpose of the Study:
- To identify risk factors for pT3a upstaging of cT1 renal tumors.
- To analyze the association between pT3a upstaging, positive surgical margins (PSM), and overall survival (OS).
Main Methods:
- Retrospective analysis of two patient cohorts undergoing PN for cT1 renal masses (N=1298 multi-center database, N=7940 National Cancer Database).
- Multivariable logistic regression to predict pT3a upstaging and its association with PSM.
- Cox proportional hazards regression to assess OS in the NCDB cohort.
Main Results:
- pT3a upstaging rates were 5.7% (multi-center) and 1.9% (NCDB).
- Older age and larger tumor size were significant predictors of pT3a upstaging.
- pT3a upstaging was associated with a higher likelihood of PSM (14.9% vs. 3.5% and 14.8% vs. 8.3%).
Conclusions:
- Increased age and larger tumor size are associated with pT3a upstaging in cT1 tumors treated with PN.
- Improved methods for identifying occult pT3a disease are needed.
- pT3a upstaging increases PSM likelihood and may affect OS.
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