Age as a potential factor influencing the pathological parameters and prognosis of disease in patients with renal cell carcinoma

Česká verzia

Authors: V. Bartoš ¹; R. Mráz ²; J. Mikuláš ²; P. Laurinc ²
Authors place of work: Fakultná nemocnica s poliklinikou v Žiline, Oddelenie patologickej anatómie, Vedúci: prim. MUDr. Pokorný Dušan ¹; Fakultná nemocnica s poliklinikou v Žiline, Urologické oddelenie, Vedúci: prim. MUDr. Mikuláš Juraj, CSc. ²
Published in the journal: Prakt. Lék. 2012; 92(6): 330-333
Category: Of different specialties

Summary

Background:
Renal cell carcinoma (RCC) represents a heterogeneous group of oncological entities, which are characterized by some age-related differences as well.

Aim:
The purpose of our study was to investigate the differences in the pathological parameters of renal cell carcinoma in relation to age of patients.

Material and methods:
The study included 143 representative RCC cases from 141 subjects (88 males, 53 females) between 18–82 years of age. Based on the age, they were stratified into 3 groups: group A (≤ 40 years), group B (41–60 years), and group C (≥ 61 years). Results: In group A, B and C, we registered 4 (2.8 %), 47 (33.4 %) and 90 (63.8 %) patients, respectively. In the youngest group, there were only conventional clear cell RCCs. In group B and C, conventional clear cell RCC predominated (81.2 % vs. 80.2 %) and percentage of the individual histological cancer types was about the same. As age increased, mean tumor size was larger (2.5 vs. 4.5 vs. 5.2 cm), percentage of stage pT1a decreased (100 % vs. 50 % vs. 35.1 %), percentage of stage pT1b (0 % vs. 18.7 % vs. 26.4 %) and pT3 (0 % vs. 25 % vs. 34.1 %) increased, Fuhrman nuclear grade 4 was more frequent (0 % vs. 14.6 % vs. 26.4 %), number of cases with regional lymph node metastasis increased (0 % vs. 6.2 % vs. 8.8 %) and necrotic (0 % vs. 35.4 % vs. 41.7 %) and sarcomatoid (0 % vs. 4.1 % vs. 13.2 %) tumor changes occurred more commonly.

Conclusion:
Our study showed, that depending on the age group, there were some differences in several pathological parameters. In general, unfavourable variables predominated in the oldest group. Whether these parameters directly reflect a different prognosis of disease in relation to age of the patients remains questionable.

Key words:
renal cell carcinoma, age, pathological parameters, prognosis

Zdroje

1. Abou El Fettouh, H.I., Cherullo, E.E., El- Jack, M., et al. Sporadic renal cell carcinoma in young adults: presentation, treatment, and outcome. Urology 2002; 60 (5): p. 806–810.

2. Bajčiová, V. Nádory ledvin u dětí, adolescentů a mladých dospělých. Rozdíly v biologii napříč věkovým spektrem. Onkologie 2011; 5(6): s. 355– 358.

3. Belej, K., Fiala, R., Jezdinská, V., Hrabec, M. Karcinom ledviny ze zběrných kanálků - kazuistika. Česká urologie 2003, 7(2): s. 40–42.

4. Bruder, E., Passera, O., Harms, D., et al.Morphologic and molecular characterization of renal cell carcinoma in children and young adults. Am J Surg Pathol 2004; 28(9): p. 1117–1132.

5. Cao, Y., Paner, G.P., Perry, K.T., et al. Renal neoplasms in younger adults: analysis of 112 tumors from a single institution according to the new 2004 World Health Organization classification and 2002 American Joint Committee on Cancer Staging System. Arch Pathol Lab Med 2005; 129(4): p. 487– 491.

6. Denzinger S, Otto W, Burger M, et al. Sporadic renal cell carcinoma in young and elderly patients: are there different clinicopathological features and disease specific survival rates ? World J Surg Oncol 2007; 5: p. 16.

7. Eggener, S.E., Rubenstein, J.N., Smith, N.D., et al. Renal tumors in young adults. J Urol 2004; 171: p. 106–110.

8. Fuhrman, S.A., Lasky, L.C., Limas, C. Prognostic significance of morphologic parameters in renal cell carcinoma. Am J Surg Pathol 1982; 6(7): p. 655–663.

9. Goetzl, M.A., Desai, M., Mansukhani, M., et al. Natural history and clinical outcome of sporadic renal cortical tumors diagnosed in the young adult. Urology 2004; 63(1): p. 41–45.

10. Gillett, M.D., Cheville, J.C., Karnes, R.J., et al. Comparison of presentation and outcome for patients 18 to 40 and 60 to 70 years old with solid renal masses. J Urol 2005; 173(6): p. 1893–1896.

11. Jemal, A., Murray, T.,Ward, E., et al. Cancer statistics, 2005. CA Cancer J Clin 2005; 55(1): p. 10-30.

12. Jun, C., Zhishun, X., Xianzhou, J., et al.Association between age and clinical characteristics of renal cell carcinoma in adult patients. Int J Urol 2006; 13(5): p. 515–519.

13. Kawaciuk, I., Hyršl, L., Dušek, P. Vliv věku, pohlaví a ECOG skóre na prognózu karcinomu ledviny. Čes Urol 2005; 9(3): s. 31–35.

14. Ku, J.H., Moon, K.C., Kwak, C., Kim, H.H. Disease-specific survival in patients with renal cell carcinoma: an audit of a large series from Korea. Jpn J Clin Oncol 2011; 41(1): p. 110–114.

15. Ochodnický, P., Křenek, P., Klimas, J., Švihra, J. Angiogenéza a renálny karcinóm: hľadanie nových biomarkerov a farmakoterapeutických postupv. Klin Urol 2008; 4(2–3): s. 75–80.

16. Rainwater, L.M., Zincke, H., Farrow, G.M., Gonchoroff, N.J. Renal cell carcinoma in young and old patients. Comparison of prognostic pathologic variables (cell type, tumor grade and stage, and DNAploidy pattern) and their impact on disease outcome. Urology 1991; 38 (1): p. 1–5.

17. Renshaw, A.A., Granter, S.R., Fletcher, J.A., et al. Renal cell carcinomas in children and young adults: increased incidence of papillary architecture and unique subtypes. Am J Surg Pathol 1999; 23(7): p. 795–802.

18. Rodríguez, A., Patard, J.J., Lobel, B. Renal cell carcinoma in young adults: incidence, disease outcome and review of the literature. Arch Esp Urol 2002; 55(8): p. 969–975.

19. Sánchez-Ortiz, R.F., Rosser, C.J., Madsen, L.T., et al. Young age is an independent prognostic factor for survival of sporadic renal cell carcinoma. J Urol 2004; 171(6 Pt 1): p. 2160–2165.

20. Suh, J.K., Oak, T., Ro, J.Y., et al. Clinicopathologic features of renal cell carcinoma in young adults: a comparison study with renal cell carcinoma in older patients. Int J Clin Exp Pathol 2009; 2(5): p. 489–493.

21. Taccoen, X., Valeri, A., Descotes, J.L., et al. Renal cell carcinoma in adults 40 years old or less: young age is an independent prognostic factor for cancer-specific survival. Eur Urol 2007; 51(4): p. 980–987.

22. Tešľa, Ľ., Nagy, V., Valanský, L. Prognostické faktory a modely u pacientov s karcinómom obličky – súčasný prehľad. Klin. Urol 2010; 6(3): s. 124– 130.

23. ThoroddsenA, Einarsson GV, Hardarson S. et al. Renal cell carcinoma in young compared to older patients: Comparison of clinicopathological risk factors and survival. Scand J Urol Nephrol 2008, 42 (2): p. 121–125.

24. Vít, V. Nádorové markery u renálního karcinomu: pomoc přii diagnostice, prognóze, léčbě a sledování. Urol List 2010; 8(2): s. 11-15.

25. Yusim, I., Mermershtain, W., Neulander, E., et al. Influence of age on the prognosis of patients with renal cell carcinoma (RCC). Onkologie 2002; 25(6): p. 548-550.

26. Zugor, V., Fridel, S., Lausen, B., et al. Renal cell carcinoma under 35 years of age: comparision of survival rates for symptomatic and asymptomatic patients. Int Urol Nephrol 2008; 40(2): p. 289–293.