Tumor Size is Associated With Malignant Potential in Renal Cell Carcinoma Cases

R. Houston Thompson, Jordan M. Kurta, Matthew Kaag, Satish K. Tickoo, Shilajit Kundu, Darren Katz, Lucas Nogueira, Victor E. Reuter, Paul Russo*

*Corresponding author for this work

Research output: Contribution to journalArticle

167 Citations (Scopus)

Abstract

Purpose: We evaluated our experience with renal cortical tumors to determine whether tumor size is associated with malignant histology and/or nuclear grade. Materials and Methods: We identified 2,675 patients treated surgically at our institution for renal cell carcinoma or a benign tumor between 1989 and 2007. Histological subtype and tumor size were obtained from our kidney cancer database and logistic regression analysis was performed. Results: Of the 2,675 tumors 311 (12%) were benign and 2,364 (88%) were renal cell carcinoma. The OR for the association of malignancy with tumor size was 1.16 (95% CI 1.11-1.22, p <0.001), indicating that each 1 cm increase in tumor size was associated with a 16% increase in the odds of malignancy. The incidence of benign tumors decreased from 38% for tumors less than 1 cm to 7% for tumors 7 cm or greater. In patients with clear cell renal cell carcinoma each 1 cm increase in tumor size increased the odds of high grade disease (Fuhrman grade 3-4) compared with low grade disease (Fuhrman grade 1-2) by 25% (OR 1.25, 95% CI 1.21-1.30, p <0.001). In this subset the incidence of high grade lesions increased from 0% for tumors less than 1 cm to 59% for tumors greater than 7 cm. Conclusions: Our results confirm previous observations suggesting that the risks of malignancy and high grade tumors increase with tumor size. Patients with small renal masses are at low risk for harboring a high grade clear cell malignancy, which may be useful during initial consultation.

Original languageEnglish (US)
Pages (from-to)2033-2036
Number of pages4
JournalJournal of Urology
Volume181
Issue number5
DOIs
StatePublished - May 1 2009

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Renal Cell Carcinoma
Neoplasms
Kidney
Kidney Neoplasms
Incidence

Keywords

  • carcinoma
  • histology
  • kidney
  • neoplasm staging
  • renal cell
  • risk

ASJC Scopus subject areas

  • Urology

Cite this

Thompson, R. H., Kurta, J. M., Kaag, M., Tickoo, S. K., Kundu, S., Katz, D., ... Russo, P. (2009). Tumor Size is Associated With Malignant Potential in Renal Cell Carcinoma Cases. Journal of Urology, 181(5), 2033-2036. https://doi.org/10.1016/j.juro.2009.01.027
Thompson, R. Houston ; Kurta, Jordan M. ; Kaag, Matthew ; Tickoo, Satish K. ; Kundu, Shilajit ; Katz, Darren ; Nogueira, Lucas ; Reuter, Victor E. ; Russo, Paul. / Tumor Size is Associated With Malignant Potential in Renal Cell Carcinoma Cases. In: Journal of Urology. 2009 ; Vol. 181, No. 5. pp. 2033-2036.
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abstract = "Purpose: We evaluated our experience with renal cortical tumors to determine whether tumor size is associated with malignant histology and/or nuclear grade. Materials and Methods: We identified 2,675 patients treated surgically at our institution for renal cell carcinoma or a benign tumor between 1989 and 2007. Histological subtype and tumor size were obtained from our kidney cancer database and logistic regression analysis was performed. Results: Of the 2,675 tumors 311 (12{\%}) were benign and 2,364 (88{\%}) were renal cell carcinoma. The OR for the association of malignancy with tumor size was 1.16 (95{\%} CI 1.11-1.22, p <0.001), indicating that each 1 cm increase in tumor size was associated with a 16{\%} increase in the odds of malignancy. The incidence of benign tumors decreased from 38{\%} for tumors less than 1 cm to 7{\%} for tumors 7 cm or greater. In patients with clear cell renal cell carcinoma each 1 cm increase in tumor size increased the odds of high grade disease (Fuhrman grade 3-4) compared with low grade disease (Fuhrman grade 1-2) by 25{\%} (OR 1.25, 95{\%} CI 1.21-1.30, p <0.001). In this subset the incidence of high grade lesions increased from 0{\%} for tumors less than 1 cm to 59{\%} for tumors greater than 7 cm. Conclusions: Our results confirm previous observations suggesting that the risks of malignancy and high grade tumors increase with tumor size. Patients with small renal masses are at low risk for harboring a high grade clear cell malignancy, which may be useful during initial consultation.",
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Thompson, RH, Kurta, JM, Kaag, M, Tickoo, SK, Kundu, S, Katz, D, Nogueira, L, Reuter, VE & Russo, P 2009, 'Tumor Size is Associated With Malignant Potential in Renal Cell Carcinoma Cases', Journal of Urology, vol. 181, no. 5, pp. 2033-2036. https://doi.org/10.1016/j.juro.2009.01.027

Tumor Size is Associated With Malignant Potential in Renal Cell Carcinoma Cases. / Thompson, R. Houston; Kurta, Jordan M.; Kaag, Matthew; Tickoo, Satish K.; Kundu, Shilajit; Katz, Darren; Nogueira, Lucas; Reuter, Victor E.; Russo, Paul.

In: Journal of Urology, Vol. 181, No. 5, 01.05.2009, p. 2033-2036.

Research output: Contribution to journalArticle

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T1 - Tumor Size is Associated With Malignant Potential in Renal Cell Carcinoma Cases

AU - Thompson, R. Houston

AU - Kurta, Jordan M.

AU - Kaag, Matthew

AU - Tickoo, Satish K.

AU - Kundu, Shilajit

AU - Katz, Darren

AU - Nogueira, Lucas

AU - Reuter, Victor E.

AU - Russo, Paul

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N2 - Purpose: We evaluated our experience with renal cortical tumors to determine whether tumor size is associated with malignant histology and/or nuclear grade. Materials and Methods: We identified 2,675 patients treated surgically at our institution for renal cell carcinoma or a benign tumor between 1989 and 2007. Histological subtype and tumor size were obtained from our kidney cancer database and logistic regression analysis was performed. Results: Of the 2,675 tumors 311 (12%) were benign and 2,364 (88%) were renal cell carcinoma. The OR for the association of malignancy with tumor size was 1.16 (95% CI 1.11-1.22, p <0.001), indicating that each 1 cm increase in tumor size was associated with a 16% increase in the odds of malignancy. The incidence of benign tumors decreased from 38% for tumors less than 1 cm to 7% for tumors 7 cm or greater. In patients with clear cell renal cell carcinoma each 1 cm increase in tumor size increased the odds of high grade disease (Fuhrman grade 3-4) compared with low grade disease (Fuhrman grade 1-2) by 25% (OR 1.25, 95% CI 1.21-1.30, p <0.001). In this subset the incidence of high grade lesions increased from 0% for tumors less than 1 cm to 59% for tumors greater than 7 cm. Conclusions: Our results confirm previous observations suggesting that the risks of malignancy and high grade tumors increase with tumor size. Patients with small renal masses are at low risk for harboring a high grade clear cell malignancy, which may be useful during initial consultation.

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KW - carcinoma

KW - histology

KW - kidney

KW - neoplasm staging

KW - renal cell

KW - risk

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