Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Jan;181(1):29-33; discussion 33-4.
doi: 10.1016/j.juro.2008.09.009. Epub 2008 Nov 13.

Histopathological characteristics of localized renal cell carcinoma correlate with tumor size: a SEER analysis

Jason Rothman  1 , Brian Egleston, Yu-Ning Wong, Kevan Iffrig, Steve Lebovitch, Robert G Uzzo
Affiliations

Histopathological characteristics of localized renal cell carcinoma correlate with tumor size: a SEER analysis

Jason Rothman et al. J Urol. 2009 Jan.

Abstract

Purpose: We determined whether a relationship exists between primary tumor size and histopathological features in cases of localized renal cancer.

Materials and methods: SEER data were used to create a cohort of patients who were diagnosed with localized node negative renal masses from 1988 to 2004. Nuclear grade was divided into low and high grade groups. We used a multinomial logistic model to predict the probability of nuclear grade and histological subtype with increasing primary tumor size.

Results: SEER data showed that 19,932 patients with localized renal masses were evaluated. The overall nuclear grade distribution was 80% and 20% for low and high grade tumors, respectively. A multinomial logistic model revealed that the probability of a high grade tumor increased with size. For each 1 cm increase in size of a primary localized renal cell carcinoma the odds of high grade disease increased by 13% (OR 1.13, p <0.001). Multinomial models also predicted that the odds of papillary vs clear cell renal cell carcinoma decreased with tumor size. Conversely the odds of chromophobe vs clear cell renal cell carcinoma increased with increasing tumor size.

Conclusions: Most localized node negative renal cell carcinomas are low grade. Although the probability of a high grade tumor increases with size, almost 85% of renal cell carcinomas smaller than 4 cm and 70% of localized renal cell carcinomas larger than 7 cm demonstrate low nuclear grade. The probability of detecting particular histological subtypes also varies with increasing tumor size. These data suggest that many localized renal tumors can grow large locally without acquiring metastatic potential.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Probability of High Grade vs. Tumor Size
Figure 2
Figure 2
Figure 2a. Probability of Clear Cell RCC vs. Tumor Size (dashed lines represent 95% Cl, solid lines represent point estimate; lines at horizontal axis represent distribution of data points) Figure 2b. Probability of Papillary RCC vs. Tumor Size Figure 2c. Probability of Chromophobe RCC vs. Tumor Size
Figure 2
Figure 2
Figure 2a. Probability of Clear Cell RCC vs. Tumor Size (dashed lines represent 95% Cl, solid lines represent point estimate; lines at horizontal axis represent distribution of data points) Figure 2b. Probability of Papillary RCC vs. Tumor Size Figure 2c. Probability of Chromophobe RCC vs. Tumor Size
Figure 2
Figure 2
Figure 2a. Probability of Clear Cell RCC vs. Tumor Size (dashed lines represent 95% Cl, solid lines represent point estimate; lines at horizontal axis represent distribution of data points) Figure 2b. Probability of Papillary RCC vs. Tumor Size Figure 2c. Probability of Chromophobe RCC vs. Tumor Size
See this image and copyright information in PMC

References

    1. Chow WH, Devesa SS, Warren JL, Fraumeni JF., Jr Rising incidence of renal cell cancer in the United States. JAMA. 2000;281:1628. - PubMed
    1. Jayson M, Sanders H. Increased incidence of serendipitously discovered renal cell carcinoma. Urology. 1998;51:203. - PubMed
    1. Chawla SN, Crispen PL, Hanlon AL, Greenberg RE, Chen DY, Uzzo RG. The Natural History of Observed Enhancing Renal Masses: Meta-Analysis and review of the World Literature. J Urol. 2006;175:425. - PubMed
    1. Volpe A, Kachura JR, Geddie WR, Evans AJ, Gharajeh A, Saravanan A, Jewett MA. Techniques, Safety, and Accuracy of Sampling of Renal Tumors by Fine Needle Aspiration and Core Biopsy. J Urol. 2007;178:379. - PubMed

    1. Surveillance, Epidemiology, and End Results (SEER) Program(www.seer.cancer.gov) Public-Use Data (1973–2004), National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2006, based on the November 2007 submission.