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    Korean J Urol. 2006 Jun;47(6):596-600. Korean.
    Published online Jun 30, 2006.
    https://doi.org/10.4111/kju.2006.47.6.596
    Copyright © 2006 The Korean Urological Association
    Original Article

    Perirenal Fat Invasion (pT3a) in Renal Cell Carcinoma Less Than 4cm in Size (cT1a): Analysis of the Prognostic and Pathological Implications

    Woong Kyu Han, Young Joon Byun,1 Yong Seong Lee, Yong Soo Kim, Koon Ho Rha, Sung Jun Hong and 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 (Email: syang313@yumc.yonsei.ac.kr )
    Received December 05, 2005; Accepted April 03, 2006.

    Abstract

    Purpose

    To investigate the incidence and histopathological factors of perirenal fat invasion (pT3a) in cT1a renal cell carcinomas. The implication for postoperative perirenal fat invasion, as a prognostic factor in patients with tumors less than 4cm tumor in size is also discussed.

    Materials and Methods

    Of 503 patients who underwent an operation for a renal cell carcinoma at our institution, between June 1995 and April 2004, we retrospectively reviewed the records of 176 with T1a renal cell carcinomas. We evaluated the pathological grade, cell type, tumor size, location and incidence of perirenal fat invasion using the Fisher's exact test. The overall survival was estimated using the Kaplan-Meier method and log-rank test, and the prognostic factors influencing the survival were estimated using the Cox proportional hazard regression model.

    Results

    In this study, a radical nephrectomy was performed in 128 men and 48 women, with a mean age of 54.6 years, ranging from 23 to 77. The mean follow-up was 31.3 months, ranging from 6 to 106 months. The average size of the renal cell carcinomas was 3.0cm, ranging from 1 to 4cm. The incidence of perirenal fat invasion in the T1a renal cell carcinomas was 5.7% (n=10). The nuclear grade (p<0.001) was a statistically significant factor in the incidence of postoperative perirenal fat invasion.

    Conclusions

    In the patients with a renal cell carcinoma less than 4cm in size (cT1a), those in the postoperative perirenal fat invasion group had a significantly poorer prognosis. The tumor size and Fuhrman nuclear grade were implicated in the incidence of perirenal fat invasion in the T1a renal cell carcinomas. Therefore, in the case of nephron sparing surgery, more precise preoperative staging of the primary tumor is required.

    Keywords
    Renal cell carcinoma; Nephrectomy; Tumor staging

    Figures

    Fig. 1
    Survival curves according to the presence of perirenal fat invasion in renal cell carcinomas 4cm or less in size (p<0.004).

    Tables

    Table 1
    Characteristics of patients with perirenal fat invasion in renal cell carcinomas of 4cm or less in size

    Table 2
    Analysis of the clinicopathological factors for perirenal fat invasion

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    MeSH Terms
    Carcinoma, Renal Cell*
    Female
    Follow-Up Studies
    Humans
    Incidence
    Male
    Neoplasm Staging
    Nephrectomy
    Nephrons
    Prognosis
    Retrospective Studies
    Metrics
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