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Research
chengzhi yan
Tianjin Medical University Second Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-0863-0061
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
To evaluate the clinicopathologic value of morphological growth patterns of small renal cell carcinoma (sRCC) and define the real demand to take a rim of healthy parenchyma to avoid positive SM.
Methods
Data was collected from 560 sRCC patients who underwent surgery from May 2010 to October 2017. 149 cases had nephron-sparing surgery (NSS) and others had radical nephrectomy (RN). All specimens were analyzed separately by two uropathologists and identified three morphological growth patterns. The presence of pseudocapsule (PC), surgical margins (SM) and other routinely variables were recorded. The relationship between growth patterns and included variables was measured by χ2 test and Fisher’s exact probability test. Survival outcomes were evaluated by Kaplan-Meier method and log-rank test.
Results
Median age of patients was 63.2 years and mean tumor diameter was 3.0 cm. 480 (85.7%) patients were clear cell RCC and 541 (96.6%) cases were pT1a stage. Peritumoral PC was detected in 512 (92.5%) specimens and the ratio of tumor invasion in PC in infiltration pattern increased obviously than other growth patterns. Similarly, the pT stage was significantly correlated with infiltration pattern as well. 149 patients underwent NSS and 3 (2.0%) of them had positive SM after operation. Statistical differences of 5-year overall survival (OS) and cancer-specific survival (CSS) existed among different morphological growth patterns, PC status and pT stages.
Conclusions
Morphological growth patterns of sRCC might be used as a potential biomarker to help operating NSS to avoid the risk of positive SM. How to distinguish different morphological growth patterns before operation and the effectiveness of growth pattern as a novel proposed parameter to direct NSS in sRCC patients deserves further exploration.
Keywords
small renal cell carcinoma, morphological growth pattern, nephron-sparing surgery, pseudocapsule, surgical margin
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Posted 24 May, 2021
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Editorial decision: Minor Revision
On 02 Jul, 2021
Review #1 received
Received 15 Jun, 2021
Reviewer #3 agreed
On 12 Jun, 2021
Review #2 received
Received 05 Jun, 2021
Reviewer #2 agreed
On 27 May, 2021
Reviews received
Received 22 May, 2021
Reviewer #1 agreed
On 22 May, 2021
Reviewers invited
Invitations sent on 22 May, 2021
Editor assigned
On 20 May, 2021
Submission checks complete
On 19 May, 2021
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On 19 May, 2021
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A new preprint design is coming!
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This preprint is under consideration at World Journal of Surgical Oncology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
chengzhi yan
Tianjin Medical University Second Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-0863-0061
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 24 May, 2021
No community comments so far
Editorial decision: Minor Revision
On 02 Jul, 2021
Review #1 received
Received 15 Jun, 2021
Reviewer #3 agreed
On 12 Jun, 2021
Review #2 received
Received 05 Jun, 2021
Reviewer #2 agreed
On 27 May, 2021
Reviews received
Received 22 May, 2021
Reviewer #1 agreed
On 22 May, 2021
Reviewers invited
Invitations sent on 22 May, 2021
Editor assigned
On 20 May, 2021
Submission checks complete
On 19 May, 2021
Editor invited
On 19 May, 2021
First submitted
On 19 May, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
To evaluate the clinicopathologic value of morphological growth patterns of small renal cell carcinoma (sRCC) and define the real demand to take a rim of healthy parenchyma to avoid positive SM.
Methods
Data was collected from 560 sRCC patients who underwent surgery from May 2010 to October 2017. 149 cases had nephron-sparing surgery (NSS) and others had radical nephrectomy (RN). All specimens were analyzed separately by two uropathologists and identified three morphological growth patterns. The presence of pseudocapsule (PC), surgical margins (SM) and other routinely variables were recorded. The relationship between growth patterns and included variables was measured by χ2 test and Fisher’s exact probability test. Survival outcomes were evaluated by Kaplan-Meier method and log-rank test.
Results
Median age of patients was 63.2 years and mean tumor diameter was 3.0 cm. 480 (85.7%) patients were clear cell RCC and 541 (96.6%) cases were pT1a stage. Peritumoral PC was detected in 512 (92.5%) specimens and the ratio of tumor invasion in PC in infiltration pattern increased obviously than other growth patterns. Similarly, the pT stage was significantly correlated with infiltration pattern as well. 149 patients underwent NSS and 3 (2.0%) of them had positive SM after operation. Statistical differences of 5-year overall survival (OS) and cancer-specific survival (CSS) existed among different morphological growth patterns, PC status and pT stages.
Conclusions
Morphological growth patterns of sRCC might be used as a potential biomarker to help operating NSS to avoid the risk of positive SM. How to distinguish different morphological growth patterns before operation and the effectiveness of growth pattern as a novel proposed parameter to direct NSS in sRCC patients deserves further exploration.
Figure 1
Figure 2
Figure 3
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