Small renal cell carcinoma: oncological outcome with tumour size.
OBJECTIVE
The aim of the study was to analyse oncological outcomes of patients with renal cell carcinoma (RCC) up to 4 cm in diameter.


METHODS
A consecutive series of 396 patients with small RCC was analysed. Tumours were stratified by diameter into three groups: 2 cm (n = 68) for tumours up to 2 cm, 3 cm (n = 172) for tumours between 2.1 and 3.0 cm, and 4 cm (n = 156) for tumours between 3.1 and 4.0 cm in diameter.


RESULTS
Tumour stages were distributed into pT1a in 95.6%, 91.9% and 87.0% and into pT3 in 4.4%, 8.1% and 13.0% for the 2 cm, 3 cm and 4 cm groups, respectively. Metastases at the time of diagnosis were found in 2.9% (n = 2), 7.5% (n = 13) and 9.1% (n = 14) of patients in the 2 cm, 3 cm and 4 cm groups, respectively. The tumour-specific survival was 100%, 96.9% and 94.6% at 1 year, 97.5%, 90.3% and 87.5% at 5 years and 97.5%, 87.3% and 84.1% at 10 years for the 2 cm, 3 cm and 4 cm groups, respectively (p < 0.05).


CONCLUSIONS
Negative prognostic features as well as worse oncological outcome increase with tumour diameter above 2 cm. These data have important implications when considering active surveillance of small renal tumours.
Department of Urology, University of Heidelberg, Germany. Sascha.Pahernik@med.uni-heidelberg.de
Sascha
S
Pahernik
Johannes
J
Huber
Jesco
J
Pfitzenmaier
Axel
A
Haferkamp
Markus
M
Hohenfellner
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000556:secondary* / Q000601:surgery; D018450:Disease Progression; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D018709:Statistics, Nonparametric; D047368:Tumor Burden; D055815:Young Adult