Evaluation of a protocol for examining nephrectomy specimens with renal cell carcinoma.
OBJECTIVE
To evaluate the practicality of use and the effectiveness of a standard protocol for examining nephrectomy specimens for renal cell carcinoma (RCC), with emphasis on the identification of vascular invasion.


METHODS
A standard protocol, devised to identify the major prognostic determinants, was used to examine 79 consecutive tumours submitted to four histopathology departments. The incidence of vascular invasion found was compared with the incidence in a historical series of tumours.


RESULTS
The protocol proved easy to follow, and appeared to increase the incidence of observed vascular invasion (40 of 69 cases compared with 69 of 176 cases in the historical series; p = 0.059, Fishers exact test, one sided)


CONCLUSIONS
If pathological prognostic determinants are to be used for clinical management, then it is important that they are identified and recorded consistently. The protocol described provides a method of examining nephrectomy specimens that can be used in routine practice and would probably reliably identify recognised prognostic variables.
Department of Pathology, University of Wales College of Medicine, Heath Park, Cardiff CF14 4XN, UK. griffithsdfr@cr.ac.uk
D F R
DF
Griffiths
N
N
Nind
C J
CJ
O'Brien
M
M
Rashid
A
A
Verghese
D002292:Carcinoma, Renal Cell / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D002985:Clinical Protocols; D004210:Dissection / Q000379:methods; D006801:Humans; D007680:Kidney Neoplasms / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D009389:Neovascularization, Pathologic / Q000473:pathology*; D009392:Nephrectomy; D011379:Prognosis