title: Prognostic value of microvascular invasion in predicting survival in renal cell carcinoma.
abstract: OBJECTIVE
  To assess microvascular tumor invasion and other clinical and histological parameters as potential prognostic factors in surgically treated renal cell carcinoma.
  
  
  METHODS
  Surgical specimens from 238 consecutive patients who underwent radical or partial surgery between 1990 and 2006 were retrospectively evaluated. The series included clinically localized or metastatic renal cell carcinoma (pT1-4; N0-1; M0-1). Disease-free and cancer-specific survival assessments were the end points with median follow-up of 75 months (range 1-189 months). Variables studied included: age, sex, tumor size, TNM 2010 classification, Fuhrman grade, histological subtype and microvascular tumor invasion.
  
  
  RESULTS
  Microvascular tumor invasion was observed in 79 patients (33,2%) and was significantly associated with age (P=.010), tumor size (P=.000), Fuhrman grade (P=.000), pT stage 2010 (P=.000),N stage 2010 (P=.000) and M stage 2010 (P=.000). Multivariate analyses determined that sex, Fuhrman grade, pT stage 2010 and histological subtipe were independent prognostic factors of disease-free survival, while sex, Fuhrman grade, pT stage 2010, M stage 2010, histological subtype and microvascular invasion were prognostic factors for cancer-specific survival.
  
  
  CONCLUSIONS
  Our study shows that microvascular tumor invasion is an independent prognostic factor for cancer-specific survival in surgically treated patients with renal cell carcinoma.
authors.affiliation: Servicio de Urología, Unidad de Gestión Clínica de Urología, Hospital Universitario Reína Sofía, Córdoba, España. Electronic address: Beatriz_santiago82@hotmail.com.
authors.forename: B
authors.initials: B
authors.lastname: Santiago-Agredano
authors.forename: J
authors.initials: J
authors.lastname: Álvarez-Kindelán
authors.forename: P
authors.initials: P
authors.lastname: Font-Ugalde
authors.forename: A
authors.initials: A
authors.lastname: Blanca-Pedregosa
authors.forename: A
authors.initials: A
authors.lastname: López-Beltrán
authors.forename: M J
authors.initials: MJ
authors.lastname: Requena-Tapia
mesh_terms: D000328:Adult; D002292:Carcinoma, Renal Cell / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D008297:Male; D055806:Microvessels; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D019043:Vascular Neoplasms / Q000401:mortality* / Q000473:pathology*
keywords: Carcinoma renal; Factor pronóstico; Invasión microvascular; Microscopic vascular invasion; Prognostic factor; Renal cell carcinoma; Supervivencia; Survival