title: Accuracy of the revised 2010 TNM classification in predicting the prognosis of patients treated for renal cell cancer in the north east of England.
abstract: BACKGROUND
  The TNM classification for renal cell cancer (RCC) should accurately predict and assign prognostic information for patients. In this study the recent 2010 revision to the TNM classification was compared with the previous 2002 classification with regard to survival outcomes.
  
  
  METHODS
  All patients having radical nephrectomy for RCC in the 5-year period 2004-8 at a tertiary referral centre were included. Pathological and radiological records were reviewed to identify TNM stage (2002 and 2010 classification) and survival data were captured.
  
  
  RESULTS
  345 patients with RCC were identified. Based on the 2002 TNM staging system and using outcomes in T1 staged tumours as a baseline, statistically significant differences in disease-specific survival were noted between patients with T1 and T3b tumours (log rank p<0.001) but not between those with T1 and T3a tumours (p=0.33). However, when tumour stage was reassigned according to the 2010 classification, patients with T3a tumours were also found to do statistically worse than T1 staged disease (p<0.001).
  
  
  CONCLUSIONS
  In our cohort, the new 2010 TNM reclassification of T3 tumours showed better correlation with predicting worsening outcomes compared with localised disease.
authors.affiliation: Department of Urology, Freeman Hospital, Newcastle upon Tyne, UK.
authors.forename: R
authors.initials: R
authors.lastname: Veeratterapillay
authors.forename: R
authors.initials: R
authors.lastname: Simren
authors.forename: A
authors.initials: A
authors.lastname: El-Sherif
authors.forename: M I
authors.initials: MI
authors.lastname: Johnson
authors.forename: N
authors.initials: N
authors.lastname: Soomro
authors.forename: R
authors.initials: R
authors.lastname: Heer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000473:pathology*; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000401:mortality / Q000592:standards*; D011379:Prognosis; D012680:Sensitivity and Specificity; D055815:Young Adult