T2a stage localized renal cell carcinoma: clinical features and analysis of impact factors of tumor metastasis
WANG qiang1, WANG Baojun2, WANG Yunpeng2, LIU Zhijia3, XU Junnan3, TANG Yuzhe4, ZHANG Xu2
1Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China; 2Department of Urology, Chinese PLA General Hospital; 3Department of Urology, the 8th Medical Center of Chinese PLA General Hospital; 4Department of Urology, Beijing Tsinghua Changgeng Hospital, School of Clinical Medicine, Tsinghua University
Abstract：Objective： To characterize the clinical features of localized renal cell carcinoma in T2a stage and to screen for factors influencing tumor metastasis. Methods： A total of 238 patients with T2a localized renal cell carcinoma treated in Urology Department of the Chinese PLA General Hospital from January 2008 to September 2016 were included. The demographic and clinical data were collected. The logistic regression analysis was used to analyze the influencing factors of tumor metastasis. Results： In this study cohort, there were 163 males (68.5%), and the male to female ratio was 2.2:1, and the median age was (54.8±11.2) years old. There were 208 patents (87.4%) with clear cell carcinoma, and 163 (76.9%) with histologically high differentiated grade, and the maximum diameter in this cohort was (8.3±0.8) cm. In these patients, 82.4% experienced with the minimally invasive surgery, and PN rate was 7.6%. No cases experienced intraoperative conversion from PN, and no cases were proved to be positive tumor margin. The median follow-up time was 24 (3-77) months. There were 27 cases (10.5%) of tumor metastasis, and 7 cases (2.7%) died, Of the 18 cases subject to partial nephrectomy, the patient was followed up for 25 (3-54) months and no tumor metastasis was observed. The logistics analysis showed a significant correlation between tumor metastasis and tumor diameter and histology of clear cell carcinoma. Conclusion： Renal clear cell carcinoma is the main pathological type in T2a stage localized renal cell carcinoma, with relatively better differential grade. PN in localized renal cell carcinoma of the T2a phase does not increase the risk of tumor metastasis. The larger the diameter of T2a renal cancer, the higher the risk of tumor metastasis, and the clear cell carcinoma had higher risk metastasis than other pathological types.
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