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Han, Joo, Lee, Byun, Rha, Hong, and Yang: Prognostic Influence of Coagulative Tumor Necrosis and the Tumor Location for T1a Renal Cell Carcinoma
Original Article
Korean Journal of Urology

Korean Journal of Urology 2006; 47(5): 456-461.

Published online: 31 May 2006

DOI: https://doi.org/10.4111/kju.2006.47.5.456

Prognostic Influence of Coagulative Tumor Necrosis and the Tumor Location for T1a Renal Cell Carcinoma

Woong Kyu Han, Jung Min Joo, Yong Seong Lee, Young Joon Byun1, Koon Ho Rha, Sung Jun Hong, Seung Choul Yang

Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.

1Department of Urology, Ewha Womans University College of Medicine, Seoul, Korea.

Corresponding author (syang313@yumc.yonsei.ac.kr)

Received 2 December 2005       Accepted 24 March 2006

Copyright © 2006 The Korean Urological Association

Abstract

Purpose

The presence of histologic coagulative necrosis in the primary tumors of patients with renal cell carcinoma has been suggested to be an important predictor of survival. This study aimed to evaluate the relationship of tumor necrosis and tumor location as compared to the other clinical features.

Materials and Methods

From June 1995 to April 2004 we retrospectively reviewed the records of 204 patients who underwent unilateral radical nephrectomy for stage T1a renal cell carcinoma. The presence of histologic coagulative necrosis in the primary tumors was recorded and the location of tumor was classified based on the computed tomography (CT) scan. Overall survival was estimated using the Kaplan-Meier method and the log-rank test, and the prognostic factors that influenced on survival were estimated using the Cox proportional hazard regression model.

Results

In this study, radical nephrectomy was performed in 148 men and 56 women with a mean age of 54.9 years (age range: 23 to 77). The mean follow-up was 31.3 months (range: 6 to 106 months). The average size of the renal cell carcinoma was 3.0cm (range: 1 to 4). The tumor locations were categorized into 2 types according to the centrality and verticality. The incidence of necrosis in T1a renal cell carcinoma was 8.7% (n=18). On the analysis of the overall survival using the log rank test, tumor necrosis (p=0.01) was a statistically significant factor.

Conclusions

For the patients with T1a renal cell carcinoma (2002 TNM stage), the presence of tumor necrosis was significantly associated with overall survival.

Keywords: Renal cell carcinoma, Necrosis, Location

Figures and Tables

Fig. 1
Associations of coagulative tumor necrosis with death from renal cell carcinoma (RCC) for 204 patients with RCC (p=0.01).
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Fig. 2
(A) Associations of tumor location (upper, mid and lower portion) with death from renal cell carcinoma (RCC) for 204 patients with RCC (p=0.42). (B) Associations of tumor location (central and peripheral portion) with death from RCC for 204 patients with RCC (p=0.70).
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Table 1
Associations of coagulative tumor necrosis with the clinico-pathologic features of T1a renal cell carcinoma
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Table 2
Associations of the tumor location for T1a renal cell carcinoma
kju-47-456-i002

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