An analysis of patients with T2 renal cell carcinoma (RCC) according to tumour size: a population‐based analysis. (12th April 2013)

• Record Type: Journal Article
• Authors: Bianchi, Marco; Becker, Andreas; Trinh, Quoc‐Dien; Abdollah, Firas; Tian, Zhe; Shariat, Shahrokh F.; Montorsi, Francesco; Perrotte, Paul; Graefen, Markus; Karakiewicz, Pierre I.; Sun, Maxine
• Is Part Of: BJU international. Volume 111:Number 8(2013:Apr.)
• Page Start: 1184
• Page End: 1190
• Publication Date: 2013-04-12
• Subjects: Genitourinary organs -- Diseases -- Periodicals; Genitourinary organs -- Surgery -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1111/bju.12084
• Languages: English
• ISSNs: 1464-4096

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bju12084-sec-0001" sec-type="section"> <title>Objective</title> <p> <list id="bju12084-list-0001" list-type="bullet"> <list-item> <p>To examine the discriminant properties of the most contemporary version of the Tumour‐Node‐Metastasis (TNM) staging for renal cell carcinoma (RCC) sub‐classification of T2 lesions according to a threshold size of 10 cm. Other thresholds were also assessed.</p> </list-item> </list> </p> </sec> <sec id="bju12084-sec-0002" sec-type="section"> <title>Patients and Methods</title> <p> <list id="bju12084-list-0002" list-type="bullet"> <list-item> <p>Between 1988 and 2006, within the Surveillance, Epidemiology, and End Results database, patients with T2 N0–2 M0–1 RCC treated with a nephrectomy were abstracted.</p> </list-item> <list-item> <p>Tumour size was evaluated according to several thresholds: ≥8, ≥9, ≥10, ≥11, and ≥12 cm. Kaplan–Meier and life tables for cancer‐specific mortality (CSM) were computed.</p> </list-item> <list-item> <p>Several Cox regression modes were fitted for prediction of CSM, using different thresholds.</p> </list-item> <list-item> <p>The predictive accuracy of various thresholds was compared using the area under the curve and methods of calibration.</p> </list-item> </list> </p> </sec> <sec id="bju12084-sec-0003" sec-type="section"> <title>Results</title> <p> <list id="bju12084-list-0003" list-type="bullet"> <list-item> <p>In all, 4963 patients were identified. Kaplan–Meier analyses showed statistically significant CSM‐free survival differences between all examined thresholds.</p> </list-item> <list-item> <p>In multivariable Cox‐regression models, all tested tumour size thresholds emerged as independent predictors of CSM.</p> </list-item> <list-item> <p>Of all thresholds, the values of 9 (0.55) and 11 cm (0.55) achieved the highest discrimination in univariable analysis, followed by 10 (0.539), 12 (0.539), and 8 cm (0.531).</p> </list-item> <list-item> <p>When the thresholds were combined with all other variables, the 11 cm (0.688) achieved the highest discrimination.</p> </list-item> </list> </p> </sec> <sec id="bju12084-sec-0004" sec-type="section"> <title>Conclusion</title> <p> <list id="bju12084-list-0004" list-type="bullet"> <list-item> <p>The discriminant properties of all examined thresholds showed very similar discriminant properties, which brings into questioning whether a dichotomization of pT2 tumours is really necessary.</p> </list-item> </list> </p> </sec> </abstract>