Renal cell carcinoma: pathological prognostic factors, staging and histopathological classification of 355 cases
Main Article Content
Keywords
Renal cell carcinoma, Kidney neoplasms, Urologic neoplasms
Abstract
Background: New morphologic entities for Renal Cell Carcinoma (RCC) that influence the prognosis have been described. Clinical staging has also undergone several modifications, the last one published in 2010 7th edition of the American Joint Committee on Cancer. The aim of this article is to determine the prevalence of histological subtypes, Fuhrman grading and clinical staging of renal cell carcinomas.
Methods: This is a retrospective, descriptive and comparative study, from January 2008 to June 2013. 355 cases of RCC were reclassified according to nuclear grading and new histopathological diagnostics and staging according to the TNM. A Kappa index was used for the diagnostic concordance and nuclear grading.
Results: Conventional renal cell carcinoma corresponded to 84.51 %, followed by chromophobe carcinoma and papillary. Less common subtypes were: multilocular cystic carcinoma, papillary clear cell carcinoma and others. Nuclear grading was directly related to the tumoral size and clinical staging (p < 0.001). The predominant stage was pT1b N0 M0, followed by pT3a N0 M0.
Conclusions: The most frequent tumor was clear cell RCC, followed by chromophobe carcinoma and papillary carcinoma. Nuclear grading, necrosis, eosinophilic cells areas with areas of sarcomatoid and rhabdoid differentiation are prognostic factors associated with an increased aggression and risk of metastases.
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