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Category: Volume 06 Issue 12 December 2018
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Title: Study of Prognostic Factors in Renal tumors in nephrectomy specimen: Experience of a tertiary care hospital

Authors: Dr Milind Anil Bhatkule, Dr Sanjay N Parate, Dr Saroj Gaikwad, Dr Shilpa Narkhede, Dr Archana Randale

 DOI: https://dx.doi.org/10.18535/jmscr/v6i12.76

Abstract

Tumours of the kidney are one of the common genitourinary malignancies.A detailed and meticulous histopathological examination of nephrectomy specimens is essential to record accepted Pathological prognostic factors. This study was undertaken to study prognostic value of histological subtypes and pTNM stage and grade of the malignant renal tumor. Nephrectomy specimen from 36 patients were studied. Patient’s clinical details, preoperative imaging and surgical details were reviewed. Each specimen was staged according to the 2017 AJCC TNM staging. Nuclear grade was assigned according to the revised WHO/ISUP grade.

Statistical Methods: Statistical analysis was performed using statistical software and descriptive statistics and survival functions were obtained by Kaplan- Meier product limit method. Univariate and multivariate analysis of factors affecting outcome of the patient were performed. Factors that were found to be significant on Univariate analysis were then subjected to multivariate analysis by Cox proportional hazards regression model

Results: Mean follow up period was 26.3 months (range 3 to 63 months). Univariate analysis revealed that histologic types stage and grade were statistically significant (P=0.009,0.007 and 0.003 respectively). Multivariate analysis model revealed that ISUP nuclear grade and stage were statistically significant (P=0.007 and 0.002 respectively).

Conclusion: This study emphasizes the pathological pTNM (AJCC) 2017 staging as having significant survival impact in the patients of Renal Cancer in the Indian subpopulation. In these patients Histologic subtype and nuclear  WHO/ISUP grade are important independent predictors of survival.Organ confined tumours with high nuclear grades need to be followed up more rigorously.

Keywords: Renal Cell carcinoma, Radical Nephrectomy, pTNM staging, ISUP grading, prognostic factors.

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Corresponding Author

Dr Sanjay Nanaji Parate

Department of Pathology, Government Medical College and Superspeciality Hospital, Nagpur, India

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