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Časopis Clinical urology – Článok New grading of clear cell renal cell carcinoma incorporating tumorr necrosis

Clinical urology

Postgraduate scientific medical journal. Magazine Slovak Association of Urology.
Period 3x per year
1336-7579
The journal is indexed in the Slovak National Bibliography, Bibliographiia Medica Slovaca (BMS) and listed to citation database CiBaMed. All articles are reviewed. The publisher does not bear any responsibility for data and opinions of particular authors of the articles or advertisements. The articles on grey pages are company promotions or non reviewed information, an author is responsible for the content. Any reproduction of the content is allowed only with direct consent of the editorial office.
Predplatné
Clinical urology
Clinical urology
Postgraduate scientific medical journal. Magazine Slovak Association of Urology.
Period 3x per year
Predplatné
Téma: 

New grading of clear cell renal cell carcinoma incorporating tumorr necrosis

Vladimír Bartoš1, Juraj Mikuláš2, Roman Mráz2

Aim: Currently, a novel 4-tiered grading system for clear cell renal cell carcinoma (RCC) has been proposed, that in addition to ‘classic’ criteria of nucleolar prominence derived from Fuhrman scheme also includes a presence/absence of tumour necrosis. In the present study we compared the differences between those two classification systems in the set of conventional clear cell RCCs. Material and methods: Study group consisted of 145 representative clear cell RCCs from 145 patients (87 men, 58 women) in the age range between 31-82 years. The biopsy samples were routinely processed and evaluated in the light microscope. Results: According to ‘classic’ 4-tiered scheme of nuclear differentiation, the most frequent was grade II (n = 59; 40.7 %), followed by grade I and III in the same number (n = 31; 21.4 %) and the least common was grade IV (n = 24; 16.5 %). Necroses were found in 44 cases (30.3 %) and their incidence was increasing with declining of tumour differentiation. After re-classification according to novel 4-tiered scheme incorporating necrosis, the most frequent was grade I (n = 86; 59.3 %) followed by grade III (n = 22; 15.2 %), grade IV (n = 21; 14.5 %) and grade II (n = 16; 11.0 %). Among all tumours, 75 cases (51.7 %) ‘persisted’ at the same grade level after re-classification. In the remaining cases, there was a one grade ‘shift’ down (in 3 cases from original grade IV into grade III, in 12 cases from grade III into grade II, and in 55 cases from grade II into grade I). There was a significant increase of grade I (from original 21.4 % to 59.3 %), while a percentage of all other grades, most markedly grade II (from original 40.7 % to 11.0 %) was reduced. Conclusion: To confirm a higher efficacy of this novel system or to recommend it in routine practice, a precise follow-up of larger number of patients would be necessary. Anyway, one of its advantages is that an integration of tumour necrosis into the grading system as a one of the crucial criteria ‘highlights’ their prognostic impact in overall clinical context, but this also requires their targeted searching during biopsy examination.

renal cell carcinoma, grading
Klin. urol. 2014; 10 (1): 7-11

Ročník 2014  Témy časopisu Clinical urology 1 / 2014

Vladimír Bartoš1, Juraj Mikuláš2, Roman Mráz2
Jozef Marenčák, Rudolf Moro, Eduard Králik, Patrícia Rusková

Jozef Marenčák, Rudolf Moro, Eduard Králik, Dymitry Lapatko
Michal Peteja, Ivan Viľcha, Ivan Minčík, Richard Ľuník

Vincent Nagy1, Ivica Lazúrová2, Ingrid Dravecká2, Jagienka Jautová3, Janette Baloghová3, Ladislav Valanský1, Ľubomír Lachváč1
Monika Kmeťová-Sivoňová1, Marta Vilčková1, Svetlana Grobarčíková2, Jana Jurečeková1, Dušan Dobrota1, Ján Kliment2

Jaroslav Beck1, Tatiana Baltesová2, Ľuboš Tešľa1, Štefan Hulík3, Erik Tóth3, Vincent Nagy1, Ladislav Valanský1, Ľuboslav Beňa2, Peter Závacký3

Ľuboš Tešľa, Vincent Nagy
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Period 3x per year
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The journal is indexed in the Slovak National Bibliography, Bibliographiia Medica Slovaca (BMS) and listed to citation database CiBaMed. All articles are reviewed. The publisher does not bear any responsibility for data and opinions of particular authors of the articles or advertisements. The articles on grey pages are company promotions or non reviewed information, an author is responsible for the content. Any reproduction of the content is allowed only with direct consent of the editorial office.
Predplatné
Clinical urology
Clinical urology
Postgraduate scientific medical journal. Magazine Slovak Association of Urology.
Period 3x per year
Predplatné