title: Relationship of pathologic factors to efficacy of sorafenib treatment in patients with metastatic clear cell renal cell carcinoma.
abstract: OBJECTIVE
  To evaluate the predictive value of growth patterns in patients undergoing sorafenib treatment for metastatic clear cell renal cell carcinomas (CCRCCs).
  
  
  METHODS
  Forty-eight patients were analyzed, each of whom underwent nephrectomy and received sorafenib treatment for metastatic CCRCC. Progression-free survival (PFS) was predicted using pathologic parameters, including pathologic stage, Fuhrman nuclear grade (FNG), the presence of a sarcomatoid component, lymphovascular invasion, tumor necrosis, and growth pattern.
  
  
  RESULTS
  Three (6%) patients showed partial response, 20 (42%) patients showed stable disease, and 25 (52%) patients showed progressive disease. Univariate analyses demonstrated that FNG, the presence of a sarcomatoid component, tumor necrosis, and growth pattern were significantly associated with PFS. In the multivariate analysis, growth pattern was the only parameter that was significantly and independently predictive of PFS.
  
  
  CONCLUSIONS
  As a novel histologic prognostic parameter, growth pattern may be useful for predicting response to sorafenib treatment.
authors.affiliation: From the Department of Urology, Toyohashi Municipal Hospital, Toyohashi, Japan;
authors.forename: Hidemori
authors.initials: H
authors.lastname: Araki
authors.affiliation: Department of Pathology, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan; tsuzuki@nagoya2.jrc.or.jp.
authors.forename: Toyonori
authors.initials: T
authors.lastname: Tsuzuki
authors.affiliation: Department of Urology, Shakaihoken Chukyo Hospital, Nagoya, Japan;
authors.forename: Tohru
authors.initials: T
authors.lastname: Kimura
authors.affiliation: Department of Urology, Kariya Toyota General Hospital, Kariya, Japan;
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Urology, Okazaki Municipal Hospital, Okazaki, Japan;
authors.forename: Shin
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan; and.
authors.forename: Naoto
authors.initials: N
authors.lastname: Sassa
authors.affiliation: Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan; and.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Yoshino
authors.affiliation: Department of Urology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan.
authors.forename: Ryohei
authors.initials: R
authors.lastname: Hattori
authors.affiliation: Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan; and.
authors.forename: Momokazu
authors.initials: M
authors.lastname: Gotoh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009392:Nephrectomy; D009536:Niacinamide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D011379:Prognosis; D000077157:Sorafenib
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib
keywords: Clear cell renal cell carcinoma; Effectiveness; Growth pattern; Metastasis; Sorafenib