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    Korean J Urol. 2006 Jun;47(6):601-606. Korean.
    Published online Jun 30, 2006.
    https://doi.org/10.4111/kju.2006.47.6.601
    Copyright © 2006 The Korean Urological Association
    Original Article

    Optimal Size Cutoff Point for Prognostic Stratification of Localized Renal Cell Carcinoma

    Dong-Gi Lee, Sung-Goo Chang and Seung Hyun Jeon
      • Department of Urology, School of Medicine, Kyung Hee University, Seoul, Korea.
    • Corresponding author (Email: juro@khnmc.or.kr )
    Received January 23, 2006; Accepted March 09, 2006.

    Abstract

    Purpose

    The purpose of this study was to evaluate the validity of the cutoff size for a localized renal cell carcinoma (RCC) by assessing the survival of RCC patients according to a series of alternative size cutoff values.

    Materials and Methods

    The outcomes of 147 patients with localized RCC, treated by radical nephrectomy at our institution, between 1984 and 2004, were retrospectively evaluated. The mean follow-up period was 54.9±32.5 months. The survival of patients with tumors smaller than a specified size cutoff was compared with that of tumors larger than the cutoff, and the most discriminating cutoff identified.

    Results

    114 and 33 patients were pT1 (77.6%) and pT2 (22.4%), respectively. There were 10 recurrences (8.8%) and 6 deaths (5.3%) in the pT1 group, and 8 recurrences (24.2%) and 8 deaths (24.2%) in the pT2 group. The differences in survival were maximized when the tumor size cutoff point was 7cm(cancer-specific survival rate: 92.0% vs. 71.5% p=0.0003, disease-free survival rate: 88.5% vs. 69.1% p=0.0092). The next significant difference was observed with a cutoff of 4cm (cancer-specific survival rate: 96.0% vs. 83.7% p=0.0467, disease-free survival rate: 96.0% vs. 78.8% p=0.0121).

    Conclusions

    Tumor size is an important prognostic factor in patients with an organ confined RCC. The established cutoff point of 7cm provided reasonable prognostic differences. A 4cm cutoff point is also feasible for separating groups with different survivals after a nephrectomy. Hence, the T1a/1b/T2 classification system is practical for the division of localized RCC.

    Keywords
    Renal cell carcinoma; Neoplasm staging; Neoplasms

    Figures

    Fig. 1
    Cancer-specific survival curves and 5 year survival rates (5YRS).

    Tables

    Table 1
    Patient characteristics

    Table 2
    Disease recurrence site in T1 and T2

    Table 3
    Cancer specific survival and disease free survival according to tumor size

    Table 4
    Univariate analysis of prognostic factors

    Table 5
    Relationships between tumor size and other prognostic factors evaluated at 4 and 5cm cutoff points

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    MeSH Terms
    Carcinoma, Renal Cell*
    Classification
    Disease-Free Survival
    Follow-Up Studies
    Humans
    Neoplasm Staging
    Nephrectomy
    Recurrence
    Retrospective Studies
    Survival Rate
    Metrics
    Share
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