Department of Urology, Osaka University Graduate School of Medicine, Osaka, Japan;
Department of Urology, Osaka University Graduate School of Medicine, Osaka, Japan.
Anticancer Res. 2023 Sep;43(9):4061-4065. doi: 10.21873/anticanres.16595.
BACKGROUND/AIM: Small renal cell carcinomas (sRCC) have drastically increased in recent years. Considering that sRCC have heterogeneous biology, it would be clinically relevant if specific clinical or pathological parameters could predict sRCC metastasis. In the present study, we aimed to assess the clinicopathological factors of pathologic T1a RCC (pT1a RCC) with or without metastasis to explore factors predicting metastasis.
The present study included 198 patients with pT1a RCC who underwent radical or partial nephrectomy at fifteen institutions belonging to the Japanese Society of Renal Cancer, between1985 and 2017. Clinicopathological parameters, including age, sex, tumour size, tumour side, histological subtype, histological nuclear grade, lymphovascular invasion, and histological growth patterns, were analysed.
Fuhrman grade 3 or 4 tumours and infiltrative tumour growth patterns were significantly higher in patients with metastasis than in those without. The most common site of synchronous metastasis was the bone in patients with pT1a RCC (65.4%), whereas for patients with post-surgery metachronous metastasis (46.2%), it was the lungs.
Histological growth pattern and nuclear grade are vital for predicting metastasis in pT1a RCC, suggesting careful long-term follow-up for such patients.
背景/目的：近年来，小肾细胞癌（sRCC）的发病率急剧上升。鉴于 sRCC 具有异质性生物学特性，如果能够通过特定的临床或病理参数预测 sRCC 的转移，这将具有重要的临床意义。本研究旨在评估有或无转移的病理 T1a 肾细胞癌（pT1a RCC）的临床病理因素，以探讨预测转移的因素。
本研究纳入了 198 名在 1985 年至 2017 年间于日本肾癌学会的 15 个机构接受根治性或部分肾切除术的 pT1a RCC 患者。分析了包括年龄、性别、肿瘤大小、肿瘤侧别、组织学亚型、组织学核分级、血管淋巴管侵犯和组织学生长模式在内的临床病理参数。
有转移的患者中 Fuhrman 分级 3 或 4 级肿瘤和浸润性肿瘤生长模式明显更高。pT1a RCC 患者中同步转移最常见的部位是骨骼（65.4%），而对于术后发生的转移（46.2%），最常见的部位是肺部。
组织学生长模式和核分级对预测 pT1a RCC 的转移至关重要，提示对这些患者应进行仔细的长期随访。
