Literature DB >> 15472406

Prognosticfactors in patients with renal cell carcinoma: is TNM (1997) staging relevant in Indian subpopulation?

A Srivastava1, A Mandhani, R Kapoor, M Jain, D Dubey, A Srivastava1, M Raghavendra, A Kumar.   

Abstract

BACKGROUND: RCC (Renal Cell Carcinoma) is a common genitourinary malignancy, but its behavior has not been studied in the Indian Subpopulation. AIMS: The aim of this study was to assess the validity of 1997 AJCC TNM staging in Indian subpopulation and also to identify independent predictors for survival in patients having RCC. SETTING AND
DESIGN: Retrospective uncontrolled analysis of patients with RCC was performed at our centre.
MATERIAL AND METHODS: Medical records of patients of undergoing radical nephrectomy at our center between 1994 to August 2003 were identified retrospectively. Medical records of 178 patients were available for analysis. Patient characteristics, preoperative imaging and surgical details were reviewed. Each tumor was staged according to the 1997 AJCC TNM classification. Nuclear grade was assigned according to the Fuhrman's grading system. STATISTICAL METHODS: Statistical analysis was performed using statistical software and descriptive statistics and survival functions were obtained. Univariate and multivariate analysis of factors affecting outcome of the patient were performed.
RESULTS: Mean follow up period was 42.3 months (range 3 to 108 months). Stage wise 5-year Cancer specific survival was 87.2% in stage 1 disease, 74.3% in stage 2, 36.4% in stage 3 and 3.1% in stage 4. Univariate analysis revealed that stage, grade and lymph node status were statistically significant (P=0.009, 0.007 and 0.003 respectively). Sub-classifying stage 1 tumors between tumor of less than 4 cm. and more than 4 cm. did not reveal any statistically significant difference in survival (P=0.32). Multivariate analysis model revealed that Fuhrman's grade and lymph node status were statistically significant (P=0.007 and 0.002 respectively).
CONCLUSION: This study validates the TNM (1997) staging for RCC as having significant survival impact in the Indian subpopulation. Sub-classifying stage 1 tumors between tumor of less than 4 cm. and more than 4 cm is not of much importance. Nuclear grade and lymph node involvement are important independent predictors of survival. Organ confined tumors with high nuclear grades need to be followed up more rigorously.

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Year:  2004        PMID: 15472406

Source DB:  PubMed          Journal:  Indian J Cancer        ISSN: 0019-509X            Impact factor:   1.224


  6 in total

1.  Histopathology of surgically treated renal tumours in young adults: a developing country perspective.

Authors:  Muhammed Mubarak; Javed I Kazi; Rehan Mohsin; Altaf Hashmi; Syed Ali Anwer Naqvi; Syed Adeeb Ul Hassan Rizvi
Journal:  J Cancer Res Clin Oncol       Date:  2011-11-16       Impact factor: 4.553

2.  Stage T1N0M0 renal cell carcinoma: the prognosis in Asian patients.

Authors:  Zhi-Ling Zhang; Wei Chen; Yong-Hong Li; Zhuo-Wei Liu; Jun-Hang Luo; Weber Lau; Min-Han Tan; Fang-Jian Zhou
Journal:  Chin J Cancer       Date:  2011-11

3.  Sub-typing of renal cell tumours; contribution of ancillary techniques.

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Journal:  Diagn Pathol       Date:  2009-06-28       Impact factor: 2.644

4.  Nephron sparing surgery: A single institution experience.

Authors:  S Agrawal; M S Jha; N Khurana; M S A Ansari; D Dubey; A Srivastava; R Kapoor; A Kumar; M Jain; A Mandhani
Journal:  Indian J Urol       Date:  2007-01

5.  Renal cell carcinoma: Impact of mode of detection on its pathological characteristics.

Authors:  Paresh Jain; R Surdas; Pallavi Aga; Manoj Jain; Rakesh Kapoor; Aneesh Srivastava; Anil Mandhani
Journal:  Indian J Urol       Date:  2009 Oct-Dec

6.  Is laparoscopic approach safe for radical nephrectomy for tumors larger than 7 cm?

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  6 in total

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