Independent Validation of the 2010 American Joint Committee on Cancer TNM Classification for Renal Cell Carcinoma: Results From a Large, Single Institution Cohort

No AccessJournal of UrologyAdult Urology1 Jun 2011Independent Validation of the 2010 American Joint Committee on Cancer TNM Classification for Renal Cell Carcinoma: Results From a Large, Single Institution Cohort Simon P. Kim, Angela L. Alt, Christopher J. Weight, Brian A. Costello, John C. Cheville, Christine Lohse, Cristine Allmer, and Bradley C. Leibovich Simon P. KimSimon P. Kim Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author , Angela L. AltAngela L. Alt Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author , Christopher J. WeightChristopher J. Weight Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author , Brian A. CostelloBrian A. Costello Department of Oncology, Mayo Clinic, Rochester, Minnesota More articles by this author , John C. ChevilleJohn C. Cheville Department of Pathology, Mayo Clinic, Rochester, Minnesota More articles by this author , Christine LohseChristine Lohse Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota More articles by this author , Cristine AllmerCristine Allmer Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota More articles by this author , and Bradley C. LeibovichBradley C. Leibovich Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.059AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: In 2010 the American Joint Committee on Cancer updated the renal cell carcinoma TNM classification. Without independent validation of the new classification its predictive ability for cancer specific survival and generalizability remains unknown. In this setting we determined the predictive ability of the 2010 TNM classification compared to that of the 2002 classification. Materials and Methods: Using the nephrectomy registry at our institution we retrospectively reviewed the records of 3,996 patients with unilateral or bilateral synchronous renal cell carcinoma treated with radical nephrectomy or nephron sparing surgery between 1970 and 2006. Cancer specific survival was estimated using the Kaplan-Meier method and predictive ability was evaluated using the concordance index. Results: There were 1,165 deaths (29.1%) from renal cell carcinoma a median of 1.9 years after surgery compared to a median followup of 7.4 years for survivors. The estimated 10-year cancer specific survival rate was 96%, 80%, 66%, 55%, 36%, 26%, 25% and 12% for patients with 2010 primary tumor classifications of pT1a, pT1b, pT2a, pT2b, pT3a, pT3b, pT3c and pT4, respectively (p <0.001). The multivariate concordance index for the 2002 and 2010 TNM classifications was 0.848 and 0.850, respectively. Conclusions: The new 2010 classification remains a robust predictor of cancer specific survival compared to the 2002 classification by dividing pT2 lesions into pT2a and pT2b, reclassifying ipsilateral adrenal involvement as pT4, reclassifying renal vein involvement as pT3a and simplifying nodal involvement as pN0 vs pN1. However, the 2010 TNM classification showed only modest improvement in predictive ability compared to the 2002 classification. References 1 AJCC Staging Manual. Edited by . Philadelphia: Springer2009. Google Scholar 2 : Reclassification of the current tumor, node, metastasis staging in pT3 renal cell carcinoma. Int J Urol2008; 15: 582. Google Scholar 3 : Proposal for reclassification of the TNM staging system in patients with locally advanced (pT3-4) renal cell carcinoma according to the cancer-related outcome. Eur Urol2007; 51: 722. 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Google Scholar © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byZhou L, Chang Y, Xu L, Liu Z, Fu Q, Yang Y, Lin Z and Xu J (2018) The Presence of Vascular Mimicry Predicts High Risk of Clear Cell Renal Cell Carcinoma after Radical NephrectomyJournal of Urology, VOL. 196, NO. 2, (335-342), Online publication date: 1-Aug-2016.Gorin M, Ball M, Pierorazio P, Tanagho Y, Bhayani S, Kaouk J, Rogers C, Stifelman M, Khalifeh A, Kumar R, Sivarajan G and Allaf M (2018) Outcomes and Predictors of Clinical T1 to Pathological T3a Tumor Up-Staging after Robotic Partial Nephrectomy: A Multi-Institutional AnalysisJournal of Urology, VOL. 190, NO. 5, (1907-1911), Online publication date: 1-Nov-2013. Volume 185Issue 6June 2011Page: 2035-2039 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordsprognosiscarcinoma, renal cellneoplasm stagingkidneymortalityMetricsAuthor Information Simon P. Kim Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Angela L. Alt Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Christopher J. Weight Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Brian A. Costello Department of Oncology, Mayo Clinic, Rochester, Minnesota More articles by this author John C. Cheville Department of Pathology, Mayo Clinic, Rochester, Minnesota More articles by this author Christine Lohse Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota More articles by this author Cristine Allmer Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota More articles by this author Bradley C. Leibovich Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Expand All Advertisement PDF downloadLoading ...