Hyung L. Kim

You have accessJournal of UrologyTuesday, May 11, 2004, 1:00 - 3:00 pm1 Apr 20041653: Safety and Efficacy of Partial Nephrectomy for all T1 Tumors Based on an International Multicenter Experience Jean-Jacques Patard, Oleg Shvarts, Allan J. Pantuck, Vincenzo Ficarra, Hyung L. Kim, Luca Cindolo, Ken Han, Alexandre De La Taille, Jacques Tostain, Walter Artibani, ClementClaude Abbou, Bernard Lobel, Dominique Chopin, Franfois Guille, Robert A. Figlin, Peter Mulders, and Arie S. Belldegrun Jean-Jacques PatardJean-Jacques Patard More articles by this author , Oleg ShvartsOleg Shvarts More articles by this author , Allan J. PantuckAllan J. Pantuck More articles by this author , Vincenzo FicarraVincenzo Ficarra More articles by this author , Hyung L. KimHyung L. Kim More articles by this author , Luca CindoloLuca Cindolo More articles by this author , Ken HanKen Han More articles by this author , Alexandre De La TailleAlexandre De La Taille More articles by this author , Jacques TostainJacques Tostain More articles by this author , Walter ArtibaniWalter Artibani More articles by this author , ClementClaude AbbouClementClaude Abbou More articles by this author , Bernard LobelBernard Lobel More articles by this author , Dominique ChopinDominique Chopin More articles by this author , Franfois GuilleFranfois Guille More articles by this author , Robert A. FiglinRobert A. Figlin More articles by this author , Peter MuldersPeter Mulders More articles by this author , and Arie S. BelldegrunArie S. Belldegrun More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)38861-XAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "1653: Safety and Efficacy of Partial Nephrectomy for all T1 Tumors Based on an International Multicenter Experience." The Journal of Urology, 171(4S), p. 437 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 171Issue 4SApril 2004Page: 437 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Jean-Jacques Patard More articles by this author Oleg Shvarts More articles by this author Allan J. Pantuck More articles by this author Vincenzo Ficarra More articles by this author Hyung L. Kim More articles by this author Luca Cindolo More articles by this author Ken Han More articles by this author Alexandre De La Taille More articles by this author Jacques Tostain More articles by this author Walter Artibani More articles by this author ClementClaude Abbou More articles by this author Bernard Lobel More articles by this author Dominique Chopin More articles by this author Franfois Guille More articles by this author Robert A. Figlin More articles by this author Peter Mulders More articles by this author Arie S. Belldegrun More articles by this author Expand All Advertisement PDF DownloadLoading ...

PURPOSE: To evaluate ability of the University of California Los Angeles Integrated Staging System (UISS) to stratify patients with localized and metastatic renal cell carcinoma (RCC) into risk groups in an international multicenter study. PATIENTS AND METHODS: 4,202 patients from eight international academic centers were classified according to the UISS, which combines TNM stage, Fuhrman grade, and Eastern Cooperative Oncology Group performance status. Distribution of the UISS categories was assessed in the overall population and in each center. RESULTS: The UISS stratified both localized and metastatic RCC into three different risk groups (P <.001). For localized RCC, the 5-year survival rates were 92%, 67%, and 44% for low-, intermediate-, and high-risk groups, respectively. A trend toward a higher risk of death was observed in all centers for increasing UISS risk category. For metastatic RCC, the 3-year survival rates were 37%, 23%, and 12% for low-, intermediate-, and high-risk groups, respectively; in 6 of 8 centers, a trend toward a higher risk of death was observed for increasing UISS risk category. A greater variability in survival rates among centers was observed for high-risk patients. CONCLUSION: This study defines the general applicability of the UISS for predicting survival in patients with RCC. The UISS is an accurate predictor of survival for patients with localized RCC applicable to external databases. Although the UISS may be useful for patients with metastatic RCC, it may be less accurate in this subset of patients due to the heterogeneity of patients and treatments.

Epithelioid angiomyolipomas (perivascular epithelioid cell tumors) of the kidney are defined as potentially malignant mesenchymal lesions that are closely related to classic angiomyolipoma. Although approximately 120 cases are published, mostly as case reports with variably used diagnostic criteria, the pathologic prognostic predictors of outcome are unknown. We analyzed the clinicopathologic parameters in a large series of 41 cases of pure epithelioid angiomyolipomas of the kidney, which we designate as pure (monotypic) epithelioid PEComas to contrast them from classic angiomyolipomas that are regarded by some as PEComas. We use the terminology "pure" to separate these cases from those that may have variable epithelioid components. The mean age of the patients was 40.7 years (range, 14 to 68 y). The male-to-female ratio was 1:1. Seventy-nine percent of patients were symptomatic at presentation with metastatic disease at onset in 12 cases. Follow-up and/or disease progression information were available for 33 of 41 cases (mean, 44.5 mo and median, 24.5 mo; range, 4 to 240); 9 patients had a history of associated tuberous sclerosis. Recurrence and metastasis were seen in 17% and 49% of patients; 33% of patients died of disease. Lymph node involvement was seen in 24% of patients; the liver (63%), lung (25%), and mesentery (18.8%) were the most common metastatic sites. Clinicopathologic parameters associated with disease progression (recurrence, metastasis, or death due to disease) in univariate analysis included associated tuberous sclerosis complex or concurrent angiomyolipoma (any metastasis, P=0.046), necrosis (metastasis at diagnosis, P=0.012), tumor size >7 cm (progression, P=0.021), extrarenal extension and/or renal vein involvement (progression, P=0.023), and carcinoma-like growth pattern (progression, P=0.040) (the 5 adverse prognostic parameters for pure epithelioid PEComas). Tumors with <2 adverse prognostic parameters (13 cases) were considered to be low risk for progression tumor, with 15% having disease progression. Tumors with 2 to 3 adverse prognostic parameters (14 cases) were considered to be "intermediate risk," with 64% having disease progression. Tumors with more than 4 or more adverse prognostic parameters (6 cases) were considered to be high risk, with all patients having disease progression. Of tumors with 3 or more adverse prognostic parameters, 80% had disease progression. An exact logistic regression analytic model showed that only carcinoma-like growth pattern and extrarenal extension and/or renal vein involvement were significant predictors of outcome (P=0.009 and 0.033, respectively). Our data of a large series with uniform definitional criteria confirm the malignant potential for pure epithelioid PEComas and provide adverse prognostic parameters for risk stratification in these patients.