| European Urology - Tumor Size Improves the Accuracy of TNM Predictions in Patients with Renal Cancer |
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| Saturday, 23 September 2006 | ||
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Volume 50, Issue 3, Pages 521-529 (September 2006) Abstract - Objectives: Current staging for renal cancer (RC) does not directly rely on tumor size. We examined the increment in accuracy related to inclusion of pathologically determined tumor size in prediction of nodal metastases (N+), distant metastases (M+), and cancer-specific survival (CSS). Methods Partial or radical nephrectomy was performed in 2245 patients with clear cell histology. Pathologic stages were T1a in 566, T1b in 490, T2 in 303, T3 in 831, and T4 in 55 patients. Tumor size was 0.5–25cm (mean, 6.8). Multivariate models relied on 1997 and 2002 TNM variables and addressed N+, M+ disease, and CCS. Their accuracy was compared according to either the presence or absence of tumor size. Results
In all univariate and multivariate models, tumor size was a statistically significant predictor of all outcomes (p≤0.001). In all multivariate models, tumor size added between 3.7% and 0.8% to predictive accuracy of either 1997 or 2002 TNM categories. Conclusions
Pierre I. Karakiewicza, Daniel J Lewinshteina, Felix K.-H. Chuna, Alberto Brigantia, Francois Guilleb, Paul Perrottea, Bernard Lobelb, Vincenzo Ficarrac, Walter Artibanic, Luca Cindolod, Jacques Tostaine, Clement-Claude Abbouf, Dominique Chopinf, Alexandre De La Taillef, Jean-Jacques PatardbTumor size represents a highly significant, multivariate, and informative predictor of RC outcomes and may warrant inclusion in future TNM revisions. a Cancer Prognostics and Health Outcomes Unit, University of Montreal, Montreal, Que., Canada b Department of Urology, University of Rennes, Rennes, France c Department of Urology, University of Verona, Verona, Italy d Urology Unit, “G. Rummo” Hospital, Benevento, Italy e Department of Urology, North Hospital, CHU of Saint Etienne, St. Etienne, France f Department of Urology, CHU Henri Mondor, Creteil, France Accepted 14 February 2006 published online 1 March 2006. doi:10.1016/j.eururo.2006.02.034
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