BACKGROUND: Renal cell carcinoma (RCC) represents 2-3% of all malignancies and accounts for approximately 90% of all kidney malignancies. An increasing proportion of RCCs are discovered incidentally, and the average tumor diameter at diagnosis has decreased over the last few decades. Small RCCs have often been regarded by many as relatively harmless. OBJECTIVE: The objective was to evaluate the incidence of local T-category distribution and lymph node and distant metastases in relation to tumor size in RCCs ≤7 cm in a nationally based patient population. DESIGN, SETTING, AND PARTICIPANTS: Data were extracted from the National Swedish Kidney Cancer Register containing 3489 RCCs diagnosed between 2005 and 2008. This is a population-based registry including 99% of all RCCs diagnosed nationwide. The study included 2033 patients having a tumor ≤7 cm in diameter. MEASUREMENTS: The size of the tumors was compared with sex, age, cause of diagnosis, Fuhrman grade, RCC type, and TNM category. RESULTS AND LIMITATIONS: Most RCCs were discovered incidentally and incidence correlated inversely to tumor size. There were 887 (43%) patients with category T1a tumors, 836 (40%) with category T1b, 174 (8%) with T3a, 131 (6%) with T3b/c, and 12 (1%) patients had invasion of adjacent organs (T4). A total of 309 (15%) patients had lymph node and/or distant metastases. Of the 177 1- to 2-cm RCCs, category T3 tumors were identified in three patients and lymph node and/or distant metastases were identified in 8 (5%). Only for tumors ≤1 cm was there neither advanced stage nor metastasis. The occurrence of locally advanced growth, lymph node and distant metastases, and high tumor grade correlated to tumor size. Patients with Fuhrman grade III or IV had a four-fold greater risk of metastases than grades I or II. CONCLUSIONS: Lymph node and distant metastases occur even in small RCCs. Risk of metastases increases with tumor size. The data clearly show that small RCCs also have a malignant potential and should be properly evaluated and adequately treated.
BACKGROUND:Renal cell carcinoma (RCC) represents 2-3% of all malignancies and accounts for approximately 90% of all kidney malignancies. An increasing proportion of RCCs are discovered incidentally, and the average tumor diameter at diagnosis has decreased over the last few decades. Small RCCs have often been regarded by many as relatively harmless. OBJECTIVE: The objective was to evaluate the incidence of local T-category distribution and lymph node and distant metastases in relation to tumor size in RCCs ≤7 cm in a nationally based patient population. DESIGN, SETTING, AND PARTICIPANTS: Data were extracted from the National Swedish Kidney Cancer Register containing 3489 RCCs diagnosed between 2005 and 2008. This is a population-based registry including 99% of all RCCs diagnosed nationwide. The study included 2033 patients having a tumor ≤7 cm in diameter. MEASUREMENTS: The size of the tumors was compared with sex, age, cause of diagnosis, Fuhrman grade, RCC type, and TNM category. RESULTS AND LIMITATIONS: Most RCCs were discovered incidentally and incidence correlated inversely to tumor size. There were 887 (43%) patients with category T1a tumors, 836 (40%) with category T1b, 174 (8%) with T3a, 131 (6%) with T3b/c, and 12 (1%) patients had invasion of adjacent organs (T4). A total of 309 (15%) patients had lymph node and/or distant metastases. Of the 177 1- to 2-cm RCCs, category T3 tumors were identified in three patients and lymph node and/or distant metastases were identified in 8 (5%). Only for tumors ≤1 cm was there neither advanced stage nor metastasis. The occurrence of locally advanced growth, lymph node and distant metastases, and high tumor grade correlated to tumor size. Patients with Fuhrman grade III or IV had a four-fold greater risk of metastases than grades I or II. CONCLUSIONS: Lymph node and distant metastases occur even in small RCCs. Risk of metastases increases with tumor size. The data clearly show that small RCCs also have a malignant potential and should be properly evaluated and adequately treated.
Authors: Kyo Chul Koo; Hanna Yoo; Tae Young Shin; Jongchan Kim; Young Deuk Choi; Koon Ho Rha; Won Sik Ham Journal: World J Urol Date: 2013-09-07 Impact factor: 4.226
Authors: Andrew W Silagy; Alejandro Sanchez; Brandon J Manley; Karim Bensalah; Axel Bex; Jose A Karam; Börje Ljungberg; Brian Shuch; A Ari Hakimi Journal: Eur Urol Focus Date: 2019-04-28
Authors: Maria João Ferreira; Ana Sílvia Pires-Luís; Márcia Vieira-Coimbra; Pedro Costa-Pinheiro; Luís Antunes; Paula C Dias; Francisco Lobo; Jorge Oliveira; Céline S Gonçalves; Bruno M Costa; Rui Henrique; Carmen Jerónimo Journal: Epigenetics Date: 2018-01-22 Impact factor: 4.528
Authors: Kara N Babaian; Megan M Merrill; Surena Matin; Pheroze Tamboli; Nizar M Tannir; Eric Jonasch; Christopher G Wood; Jose A Karam Journal: J Urol Date: 2014-02-08 Impact factor: 7.450
Authors: Roy Mano; Emily A Vertosick; Abraham Ari Hakimi; Itay A Sternberg; Daniel D Sjoberg; Melanie Bernstein; Guido Dalbagni; Jonathan A Coleman; Paul Russo Journal: Urol Oncol Date: 2016-01-12 Impact factor: 3.498