Division of Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 25, Graz, Austria.
Histopathology. 2013 Jan;62(2):237-46. doi: 10.1111/his.12001. Epub 2012 Sep 28.
A novel version of the tumour-node-metastasis (TNM) classification system for renal cell carcinoma (RCC) was introduced in 2010, although the prognostic significance with regard to different histological subtypes has not been explored. Therefore, the aim of our study was to compare the predictive ability of the 2002 and 2010 versions of the TNM classification system for clear cell and papillary RCC.
Data from 2263 consecutive clear cell and 309 papillary RCC patients, operated at a single tertiary academic centre, were evaluated. According to TNM 2010, statistically significant differences for cancer-specific survival (CSS) were observed for pT1a versus pT1b (P < 0.001) and pT3a versus pT3b (P < 0.004) in clear cell RCC; and pT1b versus pT2a (P = 0.002) and pT3b versus pT3c (P = 0.046) in papillary RCC. The c-index for CSS in clear cell RCC was 0.74 and 0.73, and in papillary RCC 0.79 and 0.78, for the 2002 and 2010 versions of the TNM classification system, respectively.
According to our data, the predictive ability of the 2010 version of the TNM classification system regarding CSS is not superior to the 2002 version, either in clear cell or in papillary RCC.
2010 年引入了一种新型的肾细胞癌(RCC)肿瘤-淋巴结-转移(TNM)分类系统,尽管尚未探讨其对不同组织学亚型的预后意义。因此,我们的研究目的是比较 2002 年和 2010 年 TNM 分类系统对透明细胞和乳头状 RCC 的预测能力。
对单中心三级学术中心手术治疗的 2263 例透明细胞和 309 例乳头状 RCC 患者的数据进行了评估。根据 TNM 2010,透明细胞 RCC 中 pT1a 与 pT1b(P<0.001)和 pT3a 与 pT3b(P<0.004)之间、乳头状 RCC 中 pT1b 与 pT2a(P=0.002)和 pT3b 与 pT3c(P=0.046)之间的癌症特异性生存率(CSS)存在统计学显著差异。透明细胞 RCC 的 CSS 的 c 指数为 0.74 和 0.73,而乳头状 RCC 的 CSS 的 c 指数为 0.79 和 0.78,分别为 2002 年和 2010 年 TNM 分类系统的版本。
根据我们的数据,2010 年 TNM 分类系统的 CSS 预测能力在透明细胞或乳头状 RCC 中均不比 2002 年版本优越。