title: [Risk factors for recurrence in pT3aN0M0 renal cell carcinoma according to 2009 TNM classification].
abstract: The TNM classification of renal cell carcinoma was updated in 2009. In this new classification system, T3a consists of tumors with renal vein involvement and tumors with fat invasion. To assess risk factors for recurrence, we retrospectively reviewed 89 patients with pT3aN0M0 renal cell carcinoma who underwent radical or partial nephrectomy between 1992 and 2011. Analyzed risk factors for recurrence were age, gender, tumor size, grade, v factor, infiltrative growth (INF), adjuvant interferon, surgical technic (radical or partial), clinical T classification, renal vein thrombus, and pathological fat invasion. The median follow-up was 52.2 months. Five-year recurrence-free survival rate was 69.0%. Within the pT3a subcategory, the five-year recurrence-free survival was 76.7% in patients with fat invasion only, 42.9% in patients with renal vein thrombus only, and 28.6% in patients with the two concomitant features. On univariate analysis, tumor size, grade, INF, clinical T classification, and renal vein thrombus were significantly associated with recurrence. On multivariate analysis, INF (p = 0.023, HR 3.927) was an independent risk factor for recurrence. In pT3aN0M0 renal cell carcinoma, INF significantly affects recurrence, and patients with both fat invasion and renal vein thrombus have worst prognosis.
authors.affiliation: The Department of Urology, Kobe City Medical Center General Hospital.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Utsunomiya
authors.affiliation: The Department of Urology, Kobe City Medical Center General Hospital.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Kono
authors.affiliation: The Department of Urology, Kobe City Medical Center General Hospital.
authors.forename: Keiyu
authors.initials: K
authors.lastname: Matsumoto
authors.affiliation: The Department of Urology, Kobe City Medical Center General Hospital.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Sumiyoshi
authors.affiliation: The Department of Urology, Kobe City Medical Center General Hospital.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Masuda
authors.affiliation: The Department of Urology, Kobe City Medical Center General Hospital.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Shiraishi
authors.affiliation: The Department of Urology, Kobe City Medical Center General Hospital.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Negoro
authors.affiliation: The Department of Urology, Kobe City Medical Center General Hospital.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsunemori
authors.affiliation: The Department of Urology, Kobe City Medical Center General Hospital.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Sugino
authors.affiliation: The Department of Urology, Kobe City Medical Center General Hospital.
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Okubo
authors.affiliation: The Department of Urology, Kobe City Medical Center General Hospital.
authors.forename: Takuya
authors.initials: T
authors.lastname: Okada
authors.affiliation: The Department of Urology, Kobe City Medical Center General Hospital.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Segawa
authors.affiliation: The Department of Urology, Kobe City Medical Center General Hospital.
authors.forename: Koei
authors.initials: K
authors.lastname: Muguruma
authors.affiliation: The Department of Urology, Kobe City Medical Center General Hospital.
authors.forename: Mutsushi
authors.initials: M
authors.lastname: Kawakita
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002292:Carcinoma, Renal Cell / Q000145:classification* / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007372:Interferons / Q000008:administration & dosage; D007680:Kidney Neoplasms / Q000145:classification* / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D018205:Neoplasms, Adipose Tissue / Q000473:pathology*; D009360:Neoplastic Cells, Circulating; D009392:Nephrectomy; D011379:Prognosis; D012082:Renal Veins / Q000473:pathology; D012307:Risk Factors; D019043:Vascular Neoplasms / Q000473:pathology*; D020246:Venous Thrombosis
chemical_list: D007372:Interferons