title: [Renal cell carcinoma: pathological prognostic factors, staging and histopathological classification of 355 cases].
abstract: BACKGROUND
  New morphologic entities for Renal Cell Carcinoma (RCC) that influence the prognosis have been described. Clinical staging has also undergone several modifications, the last one published in 2010 7th edition of the American Joint Committee on Cancer. The aim of this article is to determine the prevalence of histological subtypes, Fuhrman grading and clinical staging of renal cell carcinomas.
  
  
  METHODS
  This is a retrospective, descriptive and comparative study, from January 2008 to June 2013. 355 cases of RCC were reclassified according to nuclear grading and new histopathological diagnostics and staging according to the TNM. A Kappa index was used for the diagnostic concordance and nuclear grading.
  
  
  RESULTS
  Conventional renal cell carcinoma corresponded to 84.51 %, followed by chromophobe carcinoma and papillary. Less common subtypes were: multilocular cystic carcinoma, papillary clear cell carcinoma and others. Nuclear grading was directly related to the tumoral size and clinical staging (p < 0.001). The predominant stage was pT1b N0 M0, followed by pT3a N0 M0.
  
  
  CONCLUSIONS
  The most frequent tumor was clear cell RCC, followed by chromophobe carcinoma and papillary carcinoma. Nuclear grading, necrosis, eosinophilic cells areas with areas of sarcomatoid and rhabdoid differentiation are prognostic factors associated with an increased aggression and risk of metastases.
authors.affiliation: Servicio de Anatomía Patológica, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Distrito Federal, México. elsa_acosta25@hotmail.com.
authors.forename: Elsa
authors.initials: E
authors.lastname: Acosta-Jiménez
authors.forename: Debbie
authors.initials: D
authors.lastname: Jerónimo-Guerrero
authors.forename: María  de los Ángeles
authors.initials: M
authors.lastname: Macías-Clavijo
authors.forename: Deia
authors.initials: D
authors.lastname: Rivera-Diez
authors.forename: Liliana
authors.initials: L
authors.lastname: Hernández-Briseño
authors.forename: Edgar
authors.initials: E
authors.lastname: Beltrán-Suárez
authors.forename: Jocabed
authors.initials: J
authors.lastname: Martínez-Olivares
authors.forename: Ulises
authors.initials: U
authors.lastname: Ángeles-Garay
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002292:Carcinoma, Renal Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult
keywords: Kidney neoplasms; Renal cell carcinoma; Urologic neoplasms