Wan Song1, Byong Chang Jeong1, Seong Il Seo1, Seong Soo Jeon1, Hyun Moo Lee1, Han Yong Choi1, Hwang Gyun Jeon2. 1. Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea. 2. Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea. hwanggyun.jeon@samsung.com.
Abstract
PURPOSE: To evaluate the impact of three-dimensional tumor volume on cancer-specific survival for patients with pT1 clear-cell renal cell carcinoma (ccRCC). MATERIALS AND METHODS: We reviewed a prospectively maintained database of 917 patients who underwent radical nephrectomy or nephron-sparing surgery for unilateral, pT1 ccRCC, including 654 pT1a and 263 pT1b patients, between April 1997 and December 2010. Three-dimensional tumor volume was measured using specialized volumetric software on cross-sectional computed tomography images of a preoperative venous phase. Kaplan-Meier and Cox regression analyses were carried out. RESULTS: The median age was 54 years with a follow-up of 60.8 months. Median tumor size and volume were 3.2 cm and 17.4 cm(3), respectively. Of 917 patients, 54 (5.9 %) had died, including 32 patients with ccRCC (9 patients in pT1a and 23 patients in pT1b). On multivariate analysis, tumor size >3.2 cm and tumor volume >17.4 cm(3) were associated with cancer-specific death in pT1 ccRCC patients. When stratified by pT1a/pT1b status and analyzed on median splits, tumor size >2.5 cm was associated with cancer-specific death but not tumor volume >9.5 cm(3) in pT1a patients. However, in pT1b patients, tumor volume >62.1 cm(3) (P = 0.036, HR 2.91, 95 % CI 1.02-7.77) was highly associated with cancer-specific death but not tumor size >5.0 cm (P = 0.159, HR 1.91, 95 % CI 0.78-4.70). CONCLUSIONS: In addition to tumor size, tumor volume is associated with cancer-specific death in pT1 ccRCC patients, particularly in pT1b ccRCC but not in pT1a ccRCC.
PURPOSE: To evaluate the impact of three-dimensional tumor volume on cancer-specific survival for patients with pT1 clear-cell renal cell carcinoma (ccRCC). MATERIALS AND METHODS: We reviewed a prospectively maintained database of 917 patients who underwent radical nephrectomy or nephron-sparing surgery for unilateral, pT1 ccRCC, including 654 pT1a and 263 pT1b patients, between April 1997 and December 2010. Three-dimensional tumor volume was measured using specialized volumetric software on cross-sectional computed tomography images of a preoperative venous phase. Kaplan-Meier and Cox regression analyses were carried out. RESULTS: The median age was 54 years with a follow-up of 60.8 months. Median tumor size and volume were 3.2 cm and 17.4 cm(3), respectively. Of 917 patients, 54 (5.9 %) had died, including 32 patients with ccRCC (9 patients in pT1a and 23 patients in pT1b). On multivariate analysis, tumor size >3.2 cm and tumor volume >17.4 cm(3) were associated with cancer-specific death in pT1 ccRCC patients. When stratified by pT1a/pT1b status and analyzed on median splits, tumor size >2.5 cm was associated with cancer-specific death but not tumor volume >9.5 cm(3) in pT1a patients. However, in pT1b patients, tumor volume >62.1 cm(3) (P = 0.036, HR 2.91, 95 % CI 1.02-7.77) was highly associated with cancer-specific death but not tumor size >5.0 cm (P = 0.159, HR 1.91, 95 % CI 0.78-4.70). CONCLUSIONS: In addition to tumor size, tumor volume is associated with cancer-specific death in pT1 ccRCC patients, particularly in pT1b ccRCC but not in pT1a ccRCC.
Authors: Jacob Jorns; David D Thiel; Christine M Lohse; Adrienne Williams; Michelle L Arnold; John C Cheville; Bradley C Leibovich; Alexander S Parker Journal: BJU Int Date: 2012-02-02 Impact factor: 5.588
Authors: Maximiliano Sorbellini; Michael W Kattan; Mark E Snyder; Victor Reuter; Robert Motzer; Manlio Goetzl; James McKiernan; Paul Russo Journal: J Urol Date: 2005-01 Impact factor: 7.450
Authors: Jacob J Jorns; David D Thiel; Christine Lohse; Adrienne Williams; Michelle Arnold; John Cheville; Bradley Leibovich; Alexander S Parker Journal: Urology Date: 2012-07 Impact factor: 2.649
Authors: Sang Eun Lee; Won Ki Lee; Dae Sung Kim; Seung Hwan Doo; Hong Zoo Park; Cheol Yong Yoon; Sung Il Hwang; Hak Jong Lee; Gheeyoung Choe; Sung Kyu Hong Journal: World J Urol Date: 2010-01-30 Impact factor: 4.226
Authors: Ozgur Yaycioglu; Matthew P Rutman; Mamtha Balasubramaniam; Kenneth M Peters; Jose A Gonzalez Journal: Urology Date: 2002-07 Impact factor: 2.649
Authors: Jordan M Kurta; R Houston Thompson; Shilajit Kundu; Matthew Kaag; M Thomas Manion; Harry W Herr; Paul Russo Journal: BJU Int Date: 2008-08-14 Impact factor: 5.588