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Purpose: Few studies have evaluated the growth pattern of renal cell carcinoma (RCC) in patients with delayed treatment. This report investigated the growth rate and stage progression of incidentally discovered RCC following a long period of active surveillance. Methods: Thirty-two patients who did not receive immediate surgical treatment for renal solid masses that later proved to be RCC were reviewed retrospectively. Annual tumor growth rates were calculated according to changes in the maximal diameter on CT or MRI. Clinical and pathological characteristics associated with tumor growth rate and stage progression were analyzed. Results: The median tumor size grow from 2.14 (range, 0.30-6.70) cm to 4.33 (range, 1.40-8.80) cm after a median 46.0 months observation period. The average tumor growth rate was 0.80 (range, 0.16-3.80) cm/year. Clear cell carcinoma (0.86 cm/year) tended to grow faster than papillary cell carcinoma (0.28 cm/year) ( P = 0.066). The mean growth rate of grade 2 tumors (0.88 cm/year) was faster than that of grade 1 tumors (0.36 cm/year) ( P = 0.041). Thirteen tumors (40.6%) were upstaged at a median 48 months after initial presentation. Cox regression analysis revealed initial tumor size as the only risk factor for upstaging ( P = 0.018). No local and systemic recurrences were noted in our cohort after the intervention at a median of 47 (range, 6-248) months of follow-up. Conclusions: RCCs were found to be slow growing in a group of untreated renal cell carcinoma patients. However, some tumors progressed in stage under observation. The growth rate of RCC tended to correlate with histologic grade and histologic subtype. [ABSTRACT FROM AUTHOR]

Purpose: To discuss the pathological and clinical characteristics, treatments and prognosis of chromophobe renal cell carcinoma (CRCC). Methods: We developed a database that contained 1,870 patients who were diagnosed with renal cell carcinoma (RCC) and who underwent surgery in our hospital between 2002 and 2010. Afterward, the clinical and pathological data of 53 CRCC cases were extracted and analyzed. Results: The mean age of the 53 patients at diagnosis was 50.2 years (range, 21-88 years), and the ratio of male to female was 1:1. All tumors were unilateral and a majority of them (69.8%) were discovered incidentally. The mean tumor size was 5.8 ± 3.2 cm (range, 2-20 cm). Stage T1, T2, and T3 tumors, in accordance with 2004 TNM classification, accounted for 75.5, 13.2 and 11.3% of all cases, respectively. By histologic grading, 11.3, 73.6 and 15.1% of the tumors were G1, G2, and G3, respectively. Forty-one (77.4%) patients underwent radical nephrectomy, 12 (22.6%) underwent partial nephrectomy. Forty-five (84.9%) patients with follow-up results were alive after a mean follow-up of 34 months (range, 4-79 months). Tumor metastasis was discovered in 2 patients: one tumor metastasis was found in the liver 4 months postoperation, and the other was found in the lumbar vertebrae 47 months postoperation. No local recurrence was found. The overall survival rate was 100%. Conclusions: CRCC is an uncommon subtype of RCC, with a favorable prognosis. Chinese patients are seemingly younger at diagnosis. Prediction of prognosis is still difficult. [ABSTRACT FROM AUTHOR]

Purpose: We combined conventional clinical and pathological characteristics and pathological architectural grading scores to develop a prognostic model to identify a specific group of patients with stage I lung adenocarcinomas with poor survival following surgery. Methods: This retrospective study included 198 patients with stage I lung adenocarcinomas recruited from 2004 to 2013. Multivariate analyses were used to confirm independent risk factors, which were checked for internal validity using the bootstrapping method. The prognostic scores, derived from β-coefficients using the Cox regression model, classified patients into high- and low-risk groups. The predictive performance and discriminative ability of the model were assessed by the area under the receiver operating characteristic curve (AUC), concordance index (C-index) and Kaplan–Meier survival analyses. Results: Three risk factors were identified: T2 (rounding of β-coefficients = 81), necrosis (rounding of β-coefficients = 67), and pathological architectural score of 5–6 (rounding of β-coefficients = 58). The final prognostic score was the sum of points. The derived prognostic scores stratified patients into low- (score ≤ 103) and high- (score > 103) risk groups, with significant differences in 5-year overall survival (high vs. low risk: 49.3% vs. 88.0%, respectively; hazard ratio: 4.55; p < 0.001). The AUC for the proposed model was 0.717. The C-index of the model was 0.693. Conclusion: An integrated prognostic model was developed to discriminate resected stage I adenocarcinoma patients into low- and high-risk groups, which will help clinicians select individual treatment strategies. [ABSTRACT FROM AUTHOR]