M

Michael L. Blute

Harvard University

Publishes on Renal cell carcinoma treatment, Prostate Cancer Diagnosis and Treatment, Prostate Cancer Treatment and Research. 778 papers and 50.9k citations.

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Guideline for Management of the Clinical T1 Renal Mass
Steven C. Campbell, Andrew C. Novick, Arie S. Belldegrun et al.|The Journal of Urology|2009
Cited by 1.8k

No AccessJournal of UrologyAdult Urology1 Oct 2009Guideline for Management of the Clinical T1 Renal Massis accompanied byIncreased Tissue Factor Expression and Poor Nephroblastoma PrognosisPercutaneous Microwave Ablation or Nephrectomy for VX-2 Carcinoma in Rabbit KidneyTemporary Segmental Renal Artery Occlusion Using Reverse Phase Polymer for Bloodless Robotic Partial Nephrectomy Steven C. Campbell, Andrew C. Novick, Arie Belldegrun, Michael L. Blute, George K. Chow, Ithaar H. Derweesh, Martha M. Faraday, Jihad H. Kaouk, Raymond J. Leveillee, Surena F. Matin, Paul Russo, and Robert G. Uzzo Steven C. CampbellSteven C. Campbell Financial interest and/or other relationship with Pfizer, Sanofi Aventis, Novartis, Aventis Pharmaceuticals. More articles by this author , Andrew C. NovickAndrew C. Novick The Panel dedicates this work to Dr. Andrew Novick, who served as Chair of the Panel until his untimely death in 2008. Dr. Novick was well recognized for his contributions to renal surgery, and kidney cancer in particular. More articles by this author , Arie BelldegrunArie Belldegrun Financial interest and/or other relationship with Galil Medical, Wilex, Bayer, Pfizer, ROEI Medical, Amgen, Agensys, Hana Biosciences, Cougar Biotechnology. More articles by this author , Michael L. BluteMichael L. Blute More articles by this author , George K. ChowGeorge K. Chow More articles by this author , Ithaar H. DerweeshIthaar H. Derweesh More articles by this author , Martha M. FaradayMartha M. Faraday More articles by this author , Jihad H. KaoukJihad H. Kaouk Financial interest and/or other relationship with Endocare, Intuitive Surgical. More articles by this author , Raymond J. LeveilleeRaymond J. Leveillee Financial interest and/or other relationship with Pluromed, LMA Urology-Suisee, Boston Scientific, ACMI, Applied Medial, ValleyLab, Ethicon, Intuitive Surgical. More articles by this author , Surena F. MatinSurena F. Matin Financial interest and/or other relationship with Johnson & Johnson Wound Management. More articles by this author , Paul RussoPaul Russo Financial interest and/or other relationship with Wilex AG. More articles by this author , and Robert G. UzzoRobert G. Uzzo Financial interest and/or other relationship with Pfizer, Bayer. More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2009.07.004AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail References 1 : Kidney. In: AJCC Cancer Staging Manual. Edited by . New York: Springer Verlag2002: 323. Google Scholar 2 : Cancer statistics, 2008. CA Cancer J Clin2008; 58: 71. Google Scholar 3 : Global increases in kidney cancer incidence, 1973–1992. Eur J Cancer Prev2002; 11: 171. Google Scholar 4 : Increased incidence of serendipitously discovered renal cell carcinoma. Urology1998; 51: 203. 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Link, Google Scholar American Urological Association Education and Research, Inc., Linthicum, Maryland© 2009 by American Urological AssociationFiguresReferencesRelatedDetailsCited byMillan B, Breau R, Bhindi B, Mallick R, Tanguay S, Finelli A, Lavallée L, Pouliot F, Rendon R, So A, Dean L, Lattouf J, Basappa N and Kapoor A (2022) A Comparison of Percutaneous Ablation Therapy to Partial Nephrectomy for cT1a Renal Cancers: Results from the Canadian Kidney Cancer Information SystemJournal of Urology, VOL. 208, NO. 4, (804-812), Online publication date: 1-Oct-2022.Campbell S, Uzzo R, Karam J, Chang S, Clark P and Souter L (2021) Renal Mass and Localized Renal Cancer: Evaluation, Management, and Follow-up: AUA Guideline: Part IIJournal of Urology, VOL. 206, NO. 2, (209-218), Online publication date: 1-Aug-2021.Campbell S, Clark P, Chang S, Karam J, Souter L and Uzzo R (2021) Renal Mass and Localized Renal Cancer: Evaluation, Management, and Follow-Up: AUA Guideline: Part IJournal of 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Bylund J (2018) Examining and Understanding Value: The Cost of Preoperative Characteristics, Intraoperative Variables and Postoperative Complications of Minimally Invasive Partial NephrectomyUrology Practice, VOL. 6, NO. 4, (215-221), Online publication date: 1-Jul-2019.Kassiri B, Cheaib J and Pierorazio P (2019) Patients with Small Renal Masses Undergoing Active Surveillance—Is Yearly Chest Imaging Necessary?Journal of Urology, VOL. 201, NO. 6, (1061-1063), Online publication date: 1-Jun-2019.Sotimehin A, Patel H, Alam R, Gorin M, Johnson M, Chang P, Wagner A, McKiernan J, Allaf M and Pierorazio P (2019) Selecting Patients with Small Renal Masses for Active Surveillance: A Domain Based Score from a Prospective Cohort StudyJournal of Urology, VOL. 201, NO. 5, (886-892), Online publication date: 1-May-2019.Laguna M (2018) Re: Assessing Time of Full Renal Recovery following Minimally Invasive Partial NephrectomyJournal of Urology, VOL. 200, NO. 2, (241-242), Online publication date: 1-Aug-2018.Antonelli A, Mari A, Longo N, Novara G, Porpiglia F, Schiavina R, Ficarra V, Carini M and Minervini A (2017) Role of Clinical and Surgical Factors for the Prediction of Immediate, Early and Late Functional Results, and its Relationship with Cardiovascular Outcome after Partial Nephrectomy: Results from the Prospective Multicenter RECORd 1 ProjectJournal of Urology, VOL. 199, NO. 4, (927-932), Online publication date: 1-Apr-2018.Laguna M (2017) Re: Renal Functional Outcomes in Patients Undergoing Percutaneous Cryoablation or Partial Nephrectomy for a Solitary Renal MassJournal of Urology, VOL. 199, NO. 3, (606-606), Online publication date: 1-Mar-2018.Laguna M (2017) Re: When to Perform Preoperative Chest Computed Tomography for Renal Cancer StagingJournal of Urology, VOL. 199, NO. 2, (339-339), Online publication date: 1-Feb-2018.Zabell J, Demirjian S, Lane B, Derweesh I, Isharwal S, Suk-Ouichai C, Wu J, Palacios D and Campbell S (2017) Predictors of Long-Term Survival after Renal Cancer SurgeryJournal of Urology, VOL. 199, NO. 2, (384-392), Online publication date: 1-Feb-2018.Laguna M (2017) Re: Partial Nephrectomy versus Radical Nephrectomy for Clinical T1b and T2 Renal Tumors: A Systematic Review and Meta-Analysis of Comparative StudiesJournal of Urology, VOL. 198, NO. 6, (1204-1206), Online publication date: 1-Dec-2017.Sood A, Abdollah F, Sammon J, Menon M and Rogers C (2017) Classification of Partial Nephrectomy as an Outpatient Surgery under CMS Part B Reimbursement Program—Does the Evidence Justify the Recommendation?Urology Practice, VOL. 4, NO. 6, (444-447), Online publication date: 1-Nov-2017.Yang D, Thompson R, Zaid H, Lohse C, Rule A, Boorjian S, Leibovich B, Cheville J and Tollefson M (2017) Severity of Preoperative Proteinuria is a Risk Factor for Overall Mortality in Patients Undergoing NephrectomyJournal of Urology, VOL. 198, NO. 4, (795-802), Online publication date: 1-Oct-2017.Laguna M (2017) Re: Management of Small Renal Masses: American Society of Clinical Oncology Clinical Practice GuidelineJournal of Urology, VOL. 198, NO. 3, (480-482), Online publication date: 1-Sep-2017.Campbell S, Uzzo R, Allaf M, Bass E, Cadeddu J, Chang A, Clark P, Davis B, Derweesh I, Giambarresi L, Gervais D, Hu S, Lane B, Leibovich B and Pierorazio P (2017) Renal Mass and Localized Renal Cancer: AUA GuidelineJournal of Urology, VOL. 198, NO. 3, (520-529), Online publication date: 1-Sep-2017.Laguna M (2017) Re: Findings and Impact of Early Imaging after Partial NephrectomyJournal of Urology, VOL. 198, NO. 2, (253-254), Online publication date: 1-Aug-2017.Shah P, Moreira D, Patel V, Gaunay G, George A, Alom M, Kozel Z, Yaskiv O, Hall S, Schwartz M, Vira M, Richstone L and Kavoussi L (2017) Partial Nephrectomy is Associated with Higher Risk of Relapse Compared with Radical Nephrectomy for Clinical Stage T1 Renal Cell Carcinoma Pathologically Up Staged to T3aJournal of Urology, VOL. 198, NO. 2, (289-296), Online publication date: 1-Aug-2017.Cate F, Kapp M, Arnold S, Gellert L, Hameed O, Clark P, Wile G, Coogan A and Giannico G (2017) Core Needle Biopsy and Fine Needle Aspiration Alone or in Combination: Diagnostic Accuracy and Impact on Management of Renal MassesJournal of Urology, VOL. 197, NO. 6, (1396-1402), Online publication date: 1-Jun-2017.Lenis A, Tan H, Halpern J, Laviana A, Shuch B and Hu J (2016) Ablative Therapies for Early Stage Kidney Cancer and the Evolving Role of the UrologistUrology Practice, VOL. 4, NO. 2, (162-168), Online publication date: 1-Mar-2017.Ito T, Derweesh I, Ginzburg S, Abbosh P, Raheem O, Mirheydar H, Hamilton Z, Chen D, Smaldone M, Greenberg R, Viterbo R, Kutikov A and Uzzo R (2016) Perioperative Outcomes Following Partial Nephrectomy Performed on Patients Remaining on Antiplatelet TherapyJournal of Urology, VOL. 197, NO. 1, (31-36), Online publication date: 1-Jan-2017.Lallas C, Scotland K, Zhang M, Schaeffer D, Calvaresi A, Gomella L, Brown D, Shaw C and Trabulsi E (2016) Clinical Influences in the Multidisciplinary Management of Small Renal Masses at a Tertiary Referral CenterUrology Practice, VOL. 3, NO. 6, (468-474), Online publication date: 1-Nov-2016.Weinberg A, Wright J, Whalen M, Paulucci D, Woldu S, Berger S, Deibert C, Korets R, Hershman D, Neugut A and Badani K (2016) Use of Partial Nephrectomy after Acquisition of a Surgical Robot: A Population Based StudyUrology Practice, VOL. 3, NO. 6, (430-436), Online publication date: 1-Nov-2016.Laguna M (2016) Re: Five-Year Oncologic Outcomes after Transperitoneal Robotic Partial Nephrectomy for Renal Cell CarcinomaJournal of Urology, VOL. 196, NO. 5, (1398-1398), Online publication date: 1-Nov-2016.Patel H, Riffon M, Joice G, Johnson M, Chang P, Wagner A, McKiernan J, Trock B, Allaf M and Pierorazio P (2016) A Prospective, Comparative Study of Quality of Life among Patients with Small Renal Masses Choosing Active Surveillance and Primary InterventionJournal of Urology, VOL. 196, NO. 5, (1356-1362), Online publication date: 1-Nov-2016.Larcher A, Capitanio U, Terrone C, Volpe A, De Angelis P, Dehó F, Fossati N, Dell’Oglio P, Antonelli A, Furlan M, Simeone C, Serni S, Carini M, Minervini A, Fiori C, Porpiglia F, Briganti A, Montorsi F and Bertini R (2016) Elective Nephron Sparing Surgery Decreases Other Cause Mortality Relative to Radical Nephrectomy Only in Specific Subgroups of Patients with Renal Cell CarcinomaJournal of Urology, VOL. 196, NO. 4, (1008-1013), Online publication date: 1-Oct-2016.Pierorazio P, Johnson M, Patel H, Sozio S, Sharma R, Iyoha E, Bass E and Allaf M (2016) Management of Renal Masses and Localized Renal Cancer: Systematic Review and Meta-AnalysisJournal of Urology, VOL. 196, NO. 4, (989-999), Online publication date: 1-Oct-2016.Moskowitz D, Chang J, Ziogas A, Anton-Culver H and Clayman R (2016) Treatment for T1a Renal Cancer Substratified by Size: “Less is More”Journal of Urology, VOL. 196, NO. 4, (1000-1007), Online publication date: 1-Oct-2016.Borgmann H, Reiss A, Kurosch M, Filmann N, Frees S, Mager R, Tsaur I and Haferkamp A (2016) R.E.N.A.L. Score Outperforms PADUA Score, C-Index and DAP Score for Outcome Prediction of Nephron Sparing Surgery in a Selected CohortJournal of Urology, VOL. 196, NO. 3, (664-671), Online publication date: 1-Sep-2016.Shah P, Moreira D, Okhunov Z, Patel V, Chopra S, Razmaria A, Alom M, George A, Yaskiv O, Schwartz M, Desai M, Vira M, Richstone L, Landman J, Shalhav A, Gill I and Kavoussi L (2016) Positive Surgical Margins Increase Risk of Recurrence after Partial Nephrectomy for High Risk Renal TumorsJournal of Urology, VOL. 196, NO. 2, (327-334), Online publication date: 1-Aug-2016.Sabir S, Ahrar K and Matin S (2016) Predicting and Determining the Success of Percutaneous AblationJournal of Urology, VOL. 196, NO. 1, (7-8), Online publication date: 1-Jul-2016.Lay A, Stewart J, Canvasser N, Cadeddu J and Gahan J (2016) Likelihood of Incomplete Kidney Tumor Ablation with Radio Frequency Energy: Degree of Enhancement MattersJournal of Urology, VOL. 196, NO. 1, (41-45), Online publication date: 1-Jul-2016.Huang J, Zhang J, Wang Y, Kong W, Xue W, Liu D, Chen Y and Huang Y (2016) Comparing Zero Ischemia Laparoscopic Radio Frequency Ablation Assisted Tumor Enucleation and Laparoscopic Partial Nephrectomy for Clinical T1a Renal Tumor: A Randomized Clinical TrialJournal of Urology, VOL. 195, NO. 6, (1677-1683), Online publication date: 1-Jun-2016.Mir M, Pavan N and Parekh D (2016) Current Paradigm for Ischemia in Kidney SurgeryJournal of Urology, VOL. 195, NO. 6, (1655-1663), Online publication date: 1-Jun-2016.Laviana A, Kundavaram C, Tan H, Burke M, Niedzwiecki D, Lee R and Hu J (2016) Determining the True Costs of Treating Small Renal Masses Using Time Driven, Activity Based CostingUrology Practice, VOL. 3, NO. 3, (180-186), Online publication date: 1-May-2016.Laguna M (2016) Re: Partial vs Radical Nephrectomy for T1 Renal Tumours: An Analysis from the British Association of Urological Surgeons Nephrectomy AuditJournal of Urology, VOL. 195, NO. 5, (1377-1379), Online publication date: 1-May-2016.Patel H, Johnson M, Pierorazio P, Sozio S, Sharma R, Iyoha E, Bass E and Allaf M (2016) Diagnostic Accuracy and Risks of Biopsy in the Diagnosis of a Renal Mass Suspicious for Localized Renal Cell Carcinoma: Systematic Review of the LiteratureJournal of Urology, VOL. 195, NO. 5, (1340-1347), Online publication date: 1-May-2016.Gershman B, Psutka S, Matsumoto J, King B, Kawashima A, Morris J and Leibovich B (2015) Use of Personalized Printed 3-Dimensional Kidney Models for Simulation before Nephron Sparing Surgery: Methodology and Examples from a Case SeriesUrology Practice, VOL. 3, NO. 2, (124-133), Online publication date: 1-Mar-2016.Derweesh I (2015) Percutaneous Biopsy of Renal Masses—When is it Necessary?Journal of Urology, VOL. 195, NO. 3, (542-543), Online publication date: 1-Mar-2016.Jiménez J, Zhang Z, Zhao J, Abouassaly R, Fergany A, Gong M, Kaouk J, Krishnamurthi V, Stein R, Stephenson A and Campbell S (2015) Surgical Salvage of Thermal Ablation Failures for Renal Cell CarcinomaJournal of Urology, VOL. 195, NO. 3, (594-600), Online publication date: 1-Mar-2016.Laguna M (2015) Re: Trifecta and Optimal Perioperative Outcomes of Robotic and Laparoscopic Partial Nephrectomy in Surgical Treatment of Small Renal Masses: A Multi-Institutional StudyJournal of Urology, VOL. 195, NO. 2, (298-298), Online publication date: 1-Feb-2016.Laguna M (2015) Re: Five-Year Analysis of a Multi-Institutional Prospective Clinical Trial of Delayed Intervention and Surveillance for Small Renal Masses: The DISSRM RegistryJournal of Urology, VOL. 195, NO. 2, (297-298), Online publication date: 1-Feb-2016.Tabayoyong W, Abouassaly R, Kiechle J, Cherullo E, Meropol N, Shah N, Dong S, Thompson R, Smaldone M, Zhu H, Ialacci S and Kim S (2015) Variation in Surgical Margin Status by Surgical Approach among Patients Undergoing Partial Nephrectomy for Small Renal MassesJournal of Urology, VOL. 194, NO. 6, (1548-1553), Online publication date: 1-Dec-2015.Chang X, Liu T, Zhang F, Qian C, Ji C, Zhao X, Liu G and Guo H (2015) The Comparison of R.E.N.A.L., PADUA and Centrality Index Score in Predicting Perioperative Outcomes and Complications after Laparoscopic Radio Frequency Ablation of Renal TumorsJournal of Urology, VOL. 194, NO. 4, (897-902), Online publication date: 1-Oct-2015.Danzig M, Ghandour R, Chang P, Wagner A, Pierorazio P, Allaf M and McKiernan J (2015) Active Surveillance is Superior to Radical Nephrectomy and Equivalent to Partial Nephrectomy for Preserving Renal in Patients with Small Renal Masses: Results from the DISSRM RegistryJournal of Urology, VOL. 194, NO. 4, Online publication date: A, S, E, M, G, C, Leveillee R, Cadeddu J and Gahan J (2015) Oncologic of Radio Frequency Ablation for Small Renal Masses: Clear Cell vs of Urology, VOL. 194, NO. 3, Online publication date: A, Woldu S, A, G, Pierorazio P, J, M, G and McKiernan J (2015) Predicting Renal after Nephron Sparing SurgeryJournal of Urology, VOL. 194, NO. 3, Online publication date: M (2015) Re: Comparison of Partial Nephrectomy and Percutaneous Ablation for Renal MassesJournal of Urology, VOL. 194, NO. 2, Online publication date: B, E, T, P, L, R, T, J, Zhang Z, Kaouk J, Krishnamurthi V, Stephenson A, Fergany A, E, Uzzo R, Chen D and Campbell S (2015) A Phase Study of in Patients with Localized Renal Cell Carcinoma to of Renal of Urology, VOL. 194, NO. 2, Online publication date: M, C, T, Zhang Z, L, E, Demirjian S and Campbell S (2015) in Renal after Partial Nephrectomy: and of Urology, VOL. NO. 6, Online publication date: M (2015) Re: of the Renal A of Renal after Partial NephrectomyJournal of Urology, VOL. NO. 4, Online publication date: X, Zhang F, Liu T, Ji C, Zhao X, R, X, Wang and Guo H Radio Frequency Ablation versus Partial Nephrectomy for Clinical T1b Renal Cell Carcinoma: Long-Term Clinical and Oncologic of Urology, VOL. NO. 2, Online publication date: D, J, A, A, S, T, Tan H, M, M, E, R and M Renal Masses: A Systematic Review of Surgical and Population of Urology, VOL. NO. 1, Online publication date: T, M, Sharma N, E, J, Demirjian S, Kaouk J and Campbell S after Partial and Radical Nephrectomy in of Urology, VOL. NO. 6, Online publication date: S Renal Surgery and its Impact on Chronic Kidney A in of Urology, VOL. NO. 4, Online publication date: S, Lane B, Derweesh I, T, Fergany A and Campbell S Chronic Kidney to Surgical of Relative of and of Urology, VOL. NO. 4, Online publication date: R, Smaldone M, Kutikov A, T, J, D, Viterbo R, Greenberg R, Chen D and Uzzo R Growth and Outcomes of and Renal Masses under Active

Comparison of 1,800 Laparoscopic and Open Partial Nephrectomies for Single Renal Tumors
Inderbir S. Gill, Louis R. Kavoussi, Brian R. Lane et al.|The Journal of Urology|2007
Cited by 1.2k

PURPOSE: Laparoscopic partial nephrectomy is an increasingly performed, minimally invasive alternative to open partial nephrectomy. We compared early postoperative outcomes in 1,800 patients undergoing open partial nephrectomy by experienced surgeons with the initial experience with laparoscopic partial nephrectomy in patients with a single renal tumor 7 cm or less. MATERIALS AND METHODS: Data on 1,800 consecutive open or laparoscopic partial nephrectomies were collected prospectively or retrospectively in tumor registries at 3 large referral centers. Demographic, intraoperative, postoperative and followup data were compared between the 2 groups. RESULTS: Compared to the laparoscopic partial nephrectomy group of 771 patients the 1,028 undergoing open partial nephrectomy were a higher risk group with a greater percent presenting symptomatically with decreased performance status, impaired renal function and tumor in a solitary functioning kidney (p<0.0001). More tumors in the open partial nephrectomy group were more than 4 cm and centrally located and more proved to be malignant (p<0.0001 and 0.0003, respectively). Based on multivariate analysis laparoscopic partial nephrectomy was associated with shorter operative time (p<0.0001), decreased operative blood loss (p<0.0001) and shorter hospital stay (p<0.0001). The chance of intraoperative complications was comparable in the 2 groups. However, laparoscopic partial nephrectomy was associated with longer ischemia time (p<0.0001), more postoperative complications, particularly urological (p<0.0001), and an increased number of subsequent procedures (p<0.0001). Renal functional outcomes were similar 3 months after laparoscopic and open partial nephrectomy with 97.9% and 99.6% of renal units retaining function, respectively. Three-year cancer specific survival for patients with a single cT1N0M0 renal cell carcinoma was 99.3% and 99.2% after laparoscopic and open partial nephrectomy, respectively. CONCLUSIONS: Early experience with laparoscopic partial nephrectomy is promising. Laparoscopic partial nephrectomy offered the advantages of less operative time, decreased operative blood loss and a shorter hospital stay. When applied to patients with a single renal tumor 7 cm or less, laparoscopic partial nephrectomy was associated with additional postoperative morbidity compared to open partial nephrectomy. However, equivalent functional and early oncological outcomes were achieved.

An Outcome Prediction Model for Patients with Clear Cell Renal Cell Carcinoma Treated with Radical Nephrectomy Based on Tumor Stage, Size, Grade and Necrosis: The Ssign Score
Igor Frank, Michael L. Blute, John C. Cheville et al.|The Journal of Urology|2002
Cited by 1.1k

PURPOSE: Currently outcome prediction in renal cell carcinoma is largely based on pathological stage and tumor grade. We developed an outcome prediction model for patients treated with radical nephrectomy for clear cell renal cell carcinoma, which was based on all available clinical and pathological features significantly associated with death from renal cell carcinoma. MATERIALS AND METHODS: We identified 1,801 adult patients with unilateral clear cell renal cell carcinoma treated with radical nephrectomy between 1970 and 1998. Clinical features examined included age, sex, smoking history, and signs and symptoms at presentation. Pathological features examined included 1997 TNM stage, tumor size, nuclear grade, histological tumor necrosis, sarcomatoid component, cystic architecture, multifocality and surgical margin status. Cancer specific survival was estimated using the Kaplan-Meier method. Cox proportional hazards regression models were used to test associations between features studied and outcome. The selection of features included in the multivariate model was validated using bootstrap methodology. RESULTS: Mean followup was 9.7 years (range 0.1 to 31). Estimated cancer specific survival rates at 1, 3, 5, 7 and 10 years were 86.6%, 74.0%, 68.7%, 63.8% and 60.0%, respectively. Several features were multivariately associated with death from clear cell renal cell carcinoma, including 1997 TNM stage (p <0.001), tumor size 5 cm. or greater (p <0.001), nuclear grade (p <0.001) and histological tumor necrosis (p <0.001). CONCLUSIONS: In patients with clear cell renal cell carcinoma 1997 TNM stage, tumor size, nuclear grade and histological tumor necrosis were significantly associated with cancer specific survival. We present a scoring system based on these features that can be used to predict outcome.

Comparisons of Outcome and Prognostic Features Among Histologic Subtypes of Renal Cell Carcinoma
John C. Cheville, Christine M. Lohse, Horst Zincke et al.|The American Journal of Surgical Pathology|2003
Cited by 1.1k

Our objective was to compare cancer-specific survival and to examine associations with outcome among the histologic subtypes of renal cell carcinoma (RCC). We studied 2385 patients whose first surgery between 1970 and 2000 was a radical nephrectomy for sporadic, unilateral RCC. All RCC tumors were classified following the 1997 Union Internationale Contre le Cancer and American Joint Committee on Cancer guidelines. There were 1985 (83.2%) patients with clear cell, 270 (11.3%) with papillary, 102 (4.3%) with chromophobe, 6 (0.3%) with collecting duct, 5 (0.3%) with purely sarcomatoid RCC and no underlying histologic subtype, and 17 (0.7%) with RCC, not otherwise specified. Cancer-specific survival rates at 5 years for patients with clear cell, papillary, and chromophobe RCC were 68.9%, 87.4%, and 86.7%, respectively. Patients with clear cell RCC had a poorer prognosis compared with patients with papillary and chromophobe RCC (p <0.001). This difference in outcome was observed even after stratifying by 1997 tumor stage and nuclear grade. There was no significant difference in cancer-specific survival between patients with papillary and chromophobe RCC (p = 0.918). The 1997 TNM stage, tumor size, presence of a sarcomatoid component, and nuclear grade were significantly associated with death from clear cell, papillary, and chromophobe RCC. Histologic tumor necrosis was significantly associated with death from clear cell and chromophobe RCC, but not with death from papillary RCC. Our results demonstrate that there are significant differences in outcome and associations with outcome for the different histologic subtypes of RCC, highlighting the need for accurate subtyping.

Solid Renal Tumors: An Analysis of Pathological Features Related to Tumor Size
Igor Frank, Michael L. Blute, John C. Cheville et al.|The Journal of Urology|2003
Cited by 1.1k

PURPOSE: We examined the relationship between tumor size and malignancy among solid renal tumors, and the relationship between tumor size and RCC subtype within tumors with renal cell carcinoma (RCC). MATERIALS AND METHODS: We identified 2,770 adult patients who underwent radical nephrectomy or nephron sparing surgery for sporadic unilateral nonmetastatic solid renal tumors between 1970 and 2000. All pathology specimens were reviewed by a urological pathologist for diagnosis, and in RCC tumors, for histological subtype and nuclear grade. RESULTS: There were 376 benign (12.8%) and 2,559 (87.2%) malignant tumors. The percentage of benign tumors decreased from 46.3% for those less than 1 cm to 6.3% for those 7 cm or greater. Among RCC tumors the percentage that were clear cell increased from 25.6% for those less than 1 cm to 83.0% for tumors 7 cm or greater, while the percentage that were papillary decreased from 74.4% for those less than 1 cm to 10.0% for tumors 7 cm or greater. No RCC tumors less than 1 cm were chromophobe compared to 7.0% of tumors 7 cm or greater. The percentage of malignant tumors that were high grade RCC increased from 2.3% for those less than 1 cm to 57.7% for RCC tumors 7 cm or greater. Only 1% of all tumors less than 1 cm and 9.2% of all tumors less than 2 cm were high grade malignancies. CONCLUSIONS: As tumor size increased there was a significant increase in the odds of having a malignant compared to a benign tumor, clear cell compared to papillary RCC and high grade compared to low grade malignancy.