Change search
ReferencesLink to record
Permanent link

Direct link
Metastatic potential in renal cell carcinomas <= 7 cm: swedish kidney cancer quality register data
Show others and affiliations
2011 (English)In: European Urology, ISSN 0302-2838, E-ISSN 1873-7560, Vol. 60, no 5, 975-982 p.Article in journal (Refereed) Published
Abstract [en]

Background: Renal cell carcinoma(RCC) represents 2-3% of all malignancies and accounts for approximately 90% of all kidney malignancies. An increasing proportion of RCCs are discovered incidentally, and the average tumor diameter at diagnosis has decreased over the last few decades. Small RCCs have often been regarded by many as relatively harmless.

Objective: The objective was to evaluate the incidence of local T-category distribution and lymph node and distant metastases in relation to tumor size in RCCs <= 7 cm in a nationally based patient population. Design, setting, and participants: Data were extracted from the National Swedish Kidney Cancer Register containing 3489 RCCs diagnosed between 2005 and 2008. This is a population-based registry including 99% of all RCCs diagnosed nationwide. The study included 2033 patients having a tumor <= 7 cm in diameter.

Measurements: The size of the tumors was compared with sex, age, cause of diagnosis, Fuhrman grade, RCC type, and TNM category.

Results and limitations: Most RCCs were discovered incidentally and incidence correlated inversely to tumor size. There were 887 (43%) patients with category T1a tumors, 836 (40%) with category T1b, 174 (8%) with T3a, 131 (6%) with T3b/c, and 12 (1%) patients had invasion of adjacent organs (T4). A total of 309 (15%) patients had lymph node and/or distant metastases. Of the 177 1- to 2-cm RCCs, category T3 tumors were identified in three patients and lymph node and/or distant metastases were identified in 8 (5%). Only for tumors <= 1 cm was there neither advanced stage nor metastasis. The occurrence of locally advanced growth, lymph node and distant metastases, and high tumor grade correlated to tumor size. Patients with Fuhrman grade III or IV had a fourfold greater risk of metastases than grades I or II.

Conclusions: Lymph node and distant metastases occur even in small RCCs. Risk of metastases increases with tumor size. The data clearly show that small RCCs also have a malignant potential and should be properly evaluated and adequately treated. (C) 2011 European Association of Urology. Published by Elsevier B. V. All rights reserved.

Place, publisher, year, edition, pages
Basel: Karger , 2011. Vol. 60, no 5, 975-982 p.
Keyword [en]
Renal cell carcinoma, Tumor size, Tumor category, Lymph node metastases, Distant metastases
National Category
Urology and Nephrology
URN: urn:nbn:se:umu:diva-49538DOI: 10.1016/j.eururo.2011.06.029ISI: 000296149400025OAI: diva2:457599
Available from: 2011-11-18 Created: 2011-11-14 Last updated: 2011-11-18Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full text

Search in DiVA

By author/editor
Ljungberg, Börje
By organisation
Urology and Andrology
In the same journal
European Urology
Urology and Nephrology

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 53 hits
ReferencesLink to record
Permanent link

Direct link