Téma: 

Prognostic importance of histological presence of cystic degeneration in solid renal cell carcinoma. analysis and correlation of histopathologic parameters according to tumor size.

1Peter Weibl, 1Martin Romančík, 2Mária Letkovičová, 1Boris Kollárik, 1Vladimír Lenko, 1Ivan Lutter, 1Milan Obšitník

Aim of the study: The aim of our study was to reveal if there are some differences in histopathologic parameters, when solid versus solid tumors with cystic component and complex renal cysts were compared. Material and methods: 147 kidney tumors were reviewed retrospectively from September 2005 until March 2008. The tumors were divided into three groups according to the tumor size [(1) 1-3 cm; (2) 3.1-5 cm a (3) 5.1-7 cm]. Tumor size was correlated to histological examination (tumor type, pathological TNM stage, and nuclear (Fuhrman) grade, presence of cystic component, necrosis and hemorrhage). In subanalysis solid tumors versus tumors with cystic degeneration versus complex renal cysts up to 5cm in diameter were compared. Results: The number of benign lesions in each category was (10 %, 10.5 %, 0 %). There was no statistically significant difference between the number of malignant and benign tumors stratified by size according to the qualitative analysis. In the subanalysis when solid tumors (total of 62 pts) were compared with tumors with cystic component (25 pts) versus complex renal cysts (35 pts) up to 5 cm in greatest diameter, the number of benign lesions was (12.9 %, 4 %, 28.1 %) for each group respectively. Nuclear grade 1/2 in (74.2 %, 91.7 %, 92 %); grade 3 was (14.4 %, 8.3 %, 8 %). All tumors with cystic component were diagnosed in pathological stage pT1a/b, in the group of solid tumors 12.9 % were diagnosed in pT3a/b stage. There was no statistically significant difference between the tumor type/stage and grade according to the qualitative analysis. But there was a highly significant correlation between tumor type and grade. The higher the grade, the less common finding of presence of the cystic component in solid tumors up to 5 cm in diameter (Kendall´s Tau B). Conclusion: Cystic component of the tumor seems to be a parameter of favorable prognosis. The further studies are necessary to confirm these results followed with statistical analysis and incorporation of the cystic component into the prognostic integrated systems.

Ročník 2009  Témy časopisu Clinical urology 1 / 2009

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