근치적 신절제술 시 관찰된 동측 신의 다발성 신세포암의 빈도 및 병리조직학적 예측인자

Abstract

Purpose: We aimed to assess the influence of the clinical and pathological factors on the multifocality of renal cell carcinoma.

Materials and Methods: We retrospectively reviewed the records of 467 patients (mean age: 54.6 years) who underwent operation for renal cell carcinoma at this hospital between June 1995 and April 2004. We evaluated the pathologic stage, grade, cell type, the histological pattern, tumor necrosis, the tumor size and the features of multifocality. To determine the clinical significant factors related with multifocality in renal cell carcinoma, we used the chi square test and multiple logistic regression analysis.

Results: Of the 467 renal cell carcinomas, 27 cases (5.8%) had multifocal malignant nodules. The average size of the multifocal renal lesions was 17×12×9 mm. The incidence of multifocality was statistically higher in the patients with stage pT3 disease than in those patients with stage pT1 or pT2 disease (p<0.001), and it was also higher for those patients with nuclear grade 3 or 4 than for those patients with nuclear grade 1 and 2 (p=0.005). Only the stage had significant correlation with multifocal disease when performing multiple logistic regression analysis.

Conclusions: Our results suggest that the primary tumor stage is a risk factor for multifocality in the patients with renal cell carcinoma. Therefore, more precise preoperative staging of the primary tumor is required in case of performing nephron sparing surgery.