title: Growth pattern, an important pathologic prognostic parameter for clear cell renal cell carcinoma.
abstract: OBJECTIVE
  To assess the validity of growth pattern as a unique prognostic parameter for clear cell renal cell carcinoma (ccRCC).
  
  
  METHODS
  In total, 561 patients with pathologic tumor stage 1 (pT1), pT2, and pT3a ccRCC without preoperative metastasis were evaluated. Clinicopathologic parameters, including pathologic tumor stage, Fuhrman grade, tumor necrosis, lymphovascular invasion, and growth pattern, were analyzed to predict disease-free survival (DFS) and cancer-specific survival (CSS).
  
  
  RESULTS
  Growth patterns were defined as follows: expansive included tumors with well-circumscribed margins without normal renal tissue in the tumor, and infiltrative involved tumors with ill-circumscribed margins or normal renal tissue in the tumors. In multivariate analysis, Fuhrman grade, tumor necrosis, and growth pattern were useful predictors of DFS, whereas Fuhrman grade and growth pattern were useful predictors of CSS, although only 30 cases showed the infiltrative pattern.
  
  
  CONCLUSIONS
  Growth pattern can be considered a new prognostic parameter for ccRCC.
authors.affiliation: Dept of Pathology, Nagoya Daini Red Cross Hospital, 2-9 Myoken-cho, Showa-ku, Nagoya 466-8650, Japan; e-mail: tsuzuki@nagoya2.jrc.or.jp.
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Fukatsu
authors.forename: Toyonori
authors.initials: T
authors.lastname: Tsuzuki
authors.forename: Naoto
authors.initials: N
authors.lastname: Sassa
authors.forename: Toshinori
authors.initials: T
authors.lastname: Nishikimi
authors.forename: Tohoru
authors.initials: T
authors.lastname: Kimura
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Majima
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Yoshino
authors.forename: Ryohei
authors.initials: R
authors.lastname: Hattori
authors.forename: Momokazu
authors.initials: M
authors.lastname: Gotoh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009392:Nephrectomy; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D055815:Young Adult
keywords: Clear cell renal cell carcinoma; Growth pattern; Pathologic parameter; Postoperative; Prognosis