Prognostic value of microscopic venous invasion in renal cell carcinoma: long-term follow-up.
OBJECTIVE
To assess the prognostic value of microscopic venous invasion (MVI) in a long-term follow-up series.


METHODS
255 patients had a radical nephrectomy between 1980 and 1990 for pT1 to pT3b N0 M0 renal cell carcinoma. We reviewed the disease free, specific and overall survival after 183 months of median follow-up. Survival analyses using Kaplan-Meier and Log-rank models for univariate comparisons and Cox proportional hazards model for multivariate analyses were performed. The studied variables were: age, size, side, extracapsular invasion, renal vein invasion, local stage, Fuhrman's grade and MVI.


RESULTS
MVI was found in 74 cases (29%). The MVI was strongly correlated to metastases appearance and survival (p < 0.0001). Multivariate analysis of disease free survival showed the following independent variables: size (p < 0.0001) and Fuhrman's grade (p < 0.0001). For cancer specific survival, the analysis found size (p < 0.0001), age (p = 0.0005), Fuhrman's grade (p = 0.0035) and MVI (p = 0.016) with a relative risk of cancer related death of 2.16. Independent prognostic factors of overall survival were age (p < 0.0001), size (p < 0.0001), MVI (p = 0.015) and Fuhrman's grade (p = 0.045). The relative risk of cancer related death for MVI is 1.82.


CONCLUSIONS
It seems that MVI is an independent prognostic factor of survival for patients with pT1 to pT3b N0 M0 renal cell carcinoma.
Department of Urology, Hôpitaux Universitaires de Strasbourg, Service de Chirurgie Urologique, Pavillon Chirurgical A, 1, place de l'hôpital, 67091 Strasbourg Cedex, France.
Hervé
H
Lang
Véronique
V
Lindner
Hervé
H
Letourneux
Mael
M
Martin
Christian
C
Saussine
Didier
D
Jacqmin
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009392:Nephrectomy; D011379:Prognosis; D016019:Survival Analysis; D019043:Vascular Neoplasms / Q000401:mortality* / Q000556:secondary; D014680:Veins / Q000473:pathology