title: Multiinstitutional European validation of the 2002 TNM staging system in conventional and papillary localized renal cell carcinoma.
abstract: BACKGROUND
  The current study validated the 2002 edition of the TNM staging system in a multicenter, multinational European series of localized renal cell carcinoma (RCC).
  
  
  METHODS
  The authors analyzed the clinical data of 2217 patients who had undergone radical or partial nephrectomy for localized RCC in 7 urologic centers.
  
  
  RESULTS
  In the current study, 1065 patients (48%) were classified as having pT1a disease, 771 (34.8%) were classified as having pT1b disease, and 381 (17.2%) were classified as having pT2 disease. Tumor histotype was conventional RCC in 1886 patients (85%), papillary in 182 (8.2%) patients, chromophobe in 64 (2.9%) patients, and unclassified in 85 (3.8%) patients. The mean follow-up time was 65.36 +/- 52.09 months. The 5 and 10-year disease-specific survival probabilities were 95.3% and 91.4% in patients with pT1a disease, 91.4% and 83.4% in patients with pT1b disease, and 81.6% and 75.2% in patients with pT2 disease (log-rank test P value = 0.0000). The disease-specific survival rates of patients with pT1a RCC were significantly higher than those recorded in patients with pT1b and pT2 RCC. Similarly, the disease-specific survival probabilities of patients with pT1b RCC were significantly better than those of patients with pT2 RCC. Analyzing the seven series individually, the 2002 TNM staging system provided appropriate stratification for only one series. The 2002 TNM staging system allowed significant stratification of the cancer-related outcomes in the subgroup of patients with conventional RCC but not in those with papillary carcinomas.
  
  
  CONCLUSIONS
  The application of the 2002 TNM staging system in the current multicenter series enabled the authors to demonstrate optimal stratification of patients with localized RCC. Stratifying by tumor histotype, the data coming from the whole group analysis were reconfirmed for clear cell RCC only.
authors: Department of Urology, University of Verona, Verona, Italy. vicenzo.ficarra@univr.it
authors: Vincenzo
authors: V
authors: Ficarra
authors: Luigi
authors: L
authors: Schips
authors: François
authors: F
authors: Guillè
authors: Guorong
authors: G
authors: Li
authors: Alexandre
authors: A
authors: De La Taille
authors: Tommaso
authors: T
authors: Prayer Galetti
authors: Luca
authors: L
authors: Cindolo
authors: Giacomo
authors: G
authors: Novara
authors: Richard E
authors: RE
authors: Zigeuner
authors: Emiliano
authors: E
authors: Bratti
authors: Jacques
authors: J
authors: Tostain
authors: Vincenzo
authors: V
authors: Altieri
authors: Claude C
authors: CC
authors: Abbou
authors: Walter
authors: W
authors: Artibani
authors: Jean-Jacques
authors: JJ
authors: Patard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy; D015996:Survival Rate