Tumor size is associated with malignant potential in renal cell carcinoma cases.
Tumor size is associated with malignant potential in renal cell carcinoma cases.
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DOI：
10.1016/j.juro.2009.01.027
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发表时间：
2009-05
期刊：
影响因子：
--
通讯作者：
Russo P
中科院分区：
文献类型：
--
作者：
Thompson RH;Kurta JM;Kaag M;Tickoo SK;Kundu S;Katz D;Nogueira L;Reuter VE;Russo P
我们评估了我们在肾皮质肿瘤方面的经验，以确定肿瘤大小是否与恶性组织学和/或核分级相关。我们确定了1989年至2007年期间在纪念斯隆-凯特琳医院接受手术治疗的2,675例肾细胞癌（RCC）或良性肿瘤患者。从我们的肾癌数据库中获得组织学亚型和肿瘤大小，并进行逻辑回归分析。在2，675例肿瘤中，311例（12%）为良性，2，364例（88%）为RCC。恶性肿瘤与肿瘤大小相关的比值比为1.16（95% CI 1.11 - 1.22; p <0.001），表明肿瘤大小每增加1 cm，恶性肿瘤的比值比增加16%。良性肿瘤的百分比从小于1 cm的38%下降到7 cm或更大的7%。对于透明细胞肾细胞癌患者，肿瘤大小每增加1 cm，与低级别（Fuhrman 1 - 2级）肿瘤相比，高级别（Fuhrman 3 - 4级）肿瘤的几率增加25%（比值比1.25，95% CI 1.21 - 1.30; p <0.001）。对于该亚组，高级别肿瘤的百分比从7 cm肿瘤的0%增加。<1cm to 59% for tumors >我们的研究结果证实了以前的观察结果，即恶性肿瘤的风险和高级别肿瘤的风险随着肿瘤的大小而增加。肾脏小肿块的患者发生高级别透明细胞恶性肿瘤的风险较低，这在初次会诊时可能有用。
We evaluated our experience with renal cortical tumors to determine if tumor size is associated with malignant histology and/or nuclear grade. We identified 2,675 patients treated surgically at Memorial Sloan-Kettering for renal cell carcinoma (RCC) or a benign tumor between 1989 and 2007. Histologic subtype and tumor size were obtained from our kidney cancer database and logistic regression analyses were performed. Among the 2,675 tumors, 311 (12%) were benign while 2,364 (88%) were RCC. The odds ratio for association of malignancy with tumor size was 1.16 (95% CI 1.11–1.22; p<0.001), indicating that each 1cm increase in tumor size was associated with a 16% increase in the odds of malignancy. The percentage of benign tumors decreased from 38% for those less than 1 cm to 7% for tumors 7 cm or greater. For patients with clear cell RCC, each 1 cm increase in tumor size increased the odds of a high grade (Fuhrman grade 3–4) compared with a low grade (Fuhrman grade 1–2) tumor by 25% (odds ratio 1.25, 95% CI 1.21–1.30; p<0.001). For this subset, the percentage of high grade tumors increased from 0% for tumors <1cm to 59% for tumors >7cm. Our results confirm previous observations suggesting that the risk of malignancy and risk of high grade tumors increases with tumor size. Patients with small renal masses have a low risk for harboring a high-grade clear cell malignancy which may be useful during initial consultation.
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