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Japanese Journal of Clinical Oncology Advance Access published online on March 14, 2007
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyl152
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© 2007 Foundation for Promotion of Cancer Research

Does Tumor Size or Microvascular Invasion Affect Prognosis in Patients with Renal Cell Carcinoma?

Tomoaki Miyagawa1,, Toru Shimazui2, Shiro Hinotsu2, Takehiro Oikawa2, Noritoshi Sekido2, Naoto Miyanaga2, Koji Kawai2 and Hideyuki Akaza2

1 Department of Urology, Kitaibaraki Municipal General Hospital, Kitaibaraki, Ibaraki
2 Department of Urology, Institute of Clinical Medicine, Tsukuba University, Ibaraki, Japan

For reprints and all correspondence: Tomoaki Miyagawa, Department of Urology, Kitaibaraki Municipal General Hospital, 4-5-15 Kitacho, Otsu-cho, Kitaibaraki, Ibaraki, 319-1704 Japan. E-mail: sh-miya{at}umin.ac.jp

Received June 23, 2006; accepted October 24, 2006

Background: We retrospectively evaluated the effects of tumor size and microvascular tumor invasion on the clinical outcomes of patients who had undergone radical nephrectomy for renal cell carcinoma (RCC).

Methods: One-hundred and sixty-two patients who received radical nephrectomy for localized or locally invasive RCC from1989 to 2002 were included. We evaluated a new cut-off value for tumor size by dividing patients into groups by tumor diameter from 3.0 to 7.0 cm in 1.0 cm increments and compared the prognosis with that predicted by the 2002 TNM classification. We also re-classified localized microvascular tumor invasion as invasive disease.

Results: Univariate analyses showed a 5.0 cm cut-off provided the greatest difference in recurrence (p = 0.004) and survival (p = 0.001). Microvascular invasion made no significant difference in tumor recurrence and tumor-specific survival. However, in the new categories used in this study, survival in the locally invasive group was poor compared with the localized group.

Conclusion: Our study showed that a tumor diameter of 5.0 cm might be the critical size to determine the prognosis of patients with localized RCC. Microvascular invasion seemed to have the necessity of re-evaluation in the TNM classification for patients with RCC.

Key Words: renal cell carcinoma • tumor size • microvascular tumor invasion


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