PURPOSE: Beginning with the 2002 American Joint Committee on Cancer staging system, renal sinus muscular venous branch invasion has prognostic equivalence with renal vein invasion in renal cell carcinoma cases. To validate this presumed equivalence we compared patients with isolated muscular venous branch invasion to those with renal vein invasion and those with no confirmed vascular invasion. MATERIALS AND METHODS: From routine cataloging at our institution we identified 500 patients who underwent partial or radical nephrectomy from 2003 to 2008. After excluding patients with metastasis or noncortical renal cell carcinoma pathology we identified 85 with positive muscular venous branch invasion (+). The 259 patients with pT1-2 muscular venous branch (-) invasion and the 71 with renal vein (+) invasion served as comparison groups. We used a multivariate Cox model to control for tumor characteristics using the Kattan renal cell carcinoma nomogram. RESULTS: On multivariate analysis the risk of recurrence in the pT1-2 muscular venous branch invasion (-) group was lower than in the muscular venous branch invasion (+) group (HR 0.06, 95% CI 0.02-0.18, p < 0.001). Patients with renal vein invasion (+) had a recurrence rate similar to that in those with muscular venous branch invasion (+) (HR 0.80, 95% CI 0.39-1.65, p = 0.6). The overall survival rate was higher in the muscular venous branch invasion (-) group than in the other groups. CONCLUSIONS: Patients with muscular venous branch invasion have an outcome inferior to that in patients with pT1-2 disease. This confirms the adverse prognosis of muscular venous branch invasion and supports pathological up-staging. The prognosis of muscular venous branch invasion is similar to that of renal vein invasion, although we cannot exclude the possibility of a difference. Our findings underscore the importance of close patient followup and careful pathological assessment of the nephrectomy specimen.
PURPOSE: Beginning with the 2002 American Joint Committee on Cancer staging system, renal sinus muscular venous branch invasion has prognostic equivalence with renal vein invasion in renal cell carcinoma cases. To validate this presumed equivalence we compared patients with isolated muscular venous branch invasion to those with renal vein invasion and those with no confirmed vascular invasion. MATERIALS AND METHODS: From routine cataloging at our institution we identified 500 patients who underwent partial or radical nephrectomy from 2003 to 2008. After excluding patients with metastasis or noncortical renal cell carcinoma pathology we identified 85 with positive muscular venous branch invasion (+). The 259 patients with pT1-2muscular venous branch (-) invasion and the 71 with renal vein (+) invasion served as comparison groups. We used a multivariate Cox model to control for tumor characteristics using the Kattan renal cell carcinoma nomogram. RESULTS: On multivariate analysis the risk of recurrence in the pT1-2muscular venous branch invasion (-) group was lower than in the muscular venous branch invasion (+) group (HR 0.06, 95% CI 0.02-0.18, p < 0.001). Patients with renal vein invasion (+) had a recurrence rate similar to that in those with muscular venous branch invasion (+) (HR 0.80, 95% CI 0.39-1.65, p = 0.6). The overall survival rate was higher in the muscular venous branch invasion (-) group than in the other groups. CONCLUSIONS:Patients with muscular venous branch invasion have an outcome inferior to that in patients with pT1-2 disease. This confirms the adverse prognosis of muscular venous branch invasion and supports pathological up-staging. The prognosis of muscular venous branch invasion is similar to that of renal vein invasion, although we cannot exclude the possibility of a difference. Our findings underscore the importance of close patient followup and careful pathological assessment of the nephrectomy specimen.
Authors: Bradley C Leibovich; John C Cheville; Christine M Lohse; Horst Zincke; Eugene D Kwon; Igor Frank; R Houston Thompson; Michael L Blute Journal: J Urol Date: 2005-03 Impact factor: 7.450
Authors: R Houston Thompson; Bradley C Leibovich; John C Cheville; Christine M Lohse; Igor Frank; Eugene D Kwon; Horst Zincke; Michael L Blute Journal: J Urol Date: 2005-03 Impact factor: 7.450
Authors: Robert J Motzer; Neeraj Agarwal; Clair Beard; Graeme B Bolger; Barry Boston; Michael A Carducci; Toni K Choueiri; Robert A Figlin; Mayer Fishman; Steven L Hancock; Gary R Hudes; Eric Jonasch; Anne Kessinger; Timothy M Kuzel; Paul H Lange; Ellis G Levine; Kim A Margolin; M Dror Michaelson; Thomas Olencki; Roberto Pili; Bruce G Redman; Cary N Robertson; Lawrence H Schwartz; Joel Sheinfeld; Jue Wang Journal: J Natl Compr Canc Netw Date: 2009-06 Impact factor: 11.908
Authors: R Houston Thompson; John C Cheville; Christine M Lohse; W Scott Webster; Horst Zincke; Eugene D Kwon; Igor Frank; Michael L Blute; Bradley C Leibovich Journal: Cancer Date: 2005-07-01 Impact factor: 6.860
Authors: Marcos F Dall'Oglio; Alberto A Antunes; Alvaro S Sarkis; Alexandre Crippa; Kátia R Leite; Antonio Marmo Lucon; Miguel Srougi Journal: BJU Int Date: 2007-06-06 Impact factor: 5.588
Authors: Bradley C Leibovich; Allan J Pantuck; Matthew H T Bui; Ken Ryu-Han; Amnon Zisman; Robert Figlin; Arie Belldegrun Journal: Urol Clin North Am Date: 2003-08 Impact factor: 2.241
Authors: Frederik C Roos; Judith Weirich; Anja Victor; Amelie Elsässer; Walburgis Brenner; Stefan Biesterfeld; Christian Hampel; Joachim W Thüroff Journal: BJU Int Date: 2009-03-11 Impact factor: 5.588
Authors: Ricardo A Rendon; Anil Kapoor; Rodney Breau; Michael Leveridge; Andrew Feifer; Peter C Black; Alan So Journal: Can Urol Assoc J Date: 2014-05 Impact factor: 1.862
Authors: Michael Chevinsky; Mariam Imnadze; Alexander Sankin; Andrew Winer; Roy Mano; Christopher Jakubowski; Joseph Mashni; Daniel D Sjoberg; Ying-Bei Chen; Satish K Tickoo; Victor E Reuter; A Ari Hakimi; Paul Russo Journal: J Urol Date: 2015-02-09 Impact factor: 7.450
Authors: Nick W Liu; James D Wren; Emily Vertosick; Justin K Lee; Nicholas E Power; Nicole E Benfante; Simon Y Kimm; Manjit S Bains; Daniel D Sjoberg; Paul Russo; Jonathan A Coleman Journal: J Urol Date: 2015-09-10 Impact factor: 7.450
Authors: Mark W Ball; Michael A Gorin; Kelly T Harris; Kevin M Curtiss; George J Netto; Christian P Pavlovich; Phillip M Pierorazio; Mohamad E Allaf Journal: BJU Int Date: 2015-11-14 Impact factor: 5.588