Perinephric invasion as a prognostic factor in non-metastatic renal cell carcinoma: Analysis of a nation-wide registry program

Haruki Kume, Yukio Homma, Nobuo Shinohara, Wataru Obara, Tsunenori Kondo, Go Kimura, Hiroyuki Fujimoto, Norio Nonomura, Fumiya Hongo, Takayuki Sugiyama, Masayuki Takahashi, Hiro omi Kanayama, Tomoharu Fukumori, Masatoshi Eto

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Abstract

Objectives: Perinephric fat invasion (PFI) of renal cell carcinoma (RCC) is known to be associated with adverse pathological features and poor prognosis. We analyzed these associations using a sub-group of the RCC registry of The Cancer Registration Committee of the Japanese Urological Association. Methods: The study cohort of 2998 non-metastatic cases was retrieved from RCC registry (3648 in total). We compared clinicopathological characteristics of cases with PFI (n = 256) and without PFI (n = 2742), and investigated the impact of PFI on cancer-specific survival using univariate and multivariate analyses. Results: Compared with non-PFI cases, PFI cases were older (P = 0.003), and more likely to be hypertensive (P = 0.034) and symptomatic at presentation (P < 0.001). PFI tumors were larger (P < 0.001), and more often have sarcomatoid component (P < 0.001) and tumor thrombus (P < 0.001). Cancer-specific survival was significantly shorter in cases with PFI than without (P < 0.001). The difference in survival tended to be greater in cases with large tumors but was significant in small tumor sub-groups. Cancer-specific survival was significantly shorter in cases with both PFI and renal vein involvement (RVI) in comparison to those with PFI or RVI alone (P = 0.011, P = 0.007, respectively). On multivariate analysis PFI with and without sinus fat invasion remained as an independent risk factor along with symptom at presentation, low body mass index, hypertension, multiple tumors, large tumor size (>7.0 cm), sarcomatoid component and RVI.

Original languageEnglish
Pages (from-to)772-779
Number of pages8
JournalJapanese journal of clinical oncology
Volume49
Issue number8
DOIs
Publication statusPublished - Aug 1 2019

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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    Kume, H., Homma, Y., Shinohara, N., Obara, W., Kondo, T., Kimura, G., Fujimoto, H., Nonomura, N., Hongo, F., Sugiyama, T., Takahashi, M., Kanayama, H. O., Fukumori, T., & Eto, M. (2019). Perinephric invasion as a prognostic factor in non-metastatic renal cell carcinoma: Analysis of a nation-wide registry program. Japanese journal of clinical oncology, 49(8), 772-779. https://doi.org/10.1093/jjco/hyz143