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Objective: The aim of this study was to evaluate the relationship between prognostic factors and cancer-specific survival (CSS) in renal tumors larger than ten centimeters. Materials and Methods: We evaluated the data of 126 patients who underwent open radical nephrectomy due to a renal mass larger than 10 cm between January 2010 and June 2016. Kaplan-Meier analysis or Cox regression was used to analyze the relationship between CSS and variables. Pairwise group comparisons were also evaluated with the Log-Rank test. A p-value <0.05 was considered statistically significant. Results: Mean follow-up was 68.5 months and mean survival was 39.2 months. The relationships between tumor histopathology, stage and CSS were significant. Tumor size negatively affected CSS, but the relationship was not significant. Tumor stage (T2b, T3b), tumor thrombus, lymph node metastasis and adjuvant therapy were the most effective independent factors affecting CSS according to Cox regression analysis results. Conclusion: Although tumor size is an important prognostic factor for T2b and lower stage kidney tumors, this effect is less in larger tumors and other clinicopathological features should be considered further to predict prognosis. [ABSTRACT FROM AUTHOR]

Renal cell carcinomas (RCCs) are heterogeneous group of cancers that arise from the tubuler cells and are responsible for 80-85% of all primary renal neoplasms. Less than 5% of all RCCs are thought to be due to a hereditary syndrome. Family studies and molecular genetics have provided important insights into the molecular pathways underlying the pathogenesis of RCCs as well as new insights into classification of RCC. Morphologically based classification of RCCs has evolved over the last 3 decades with the incorporation of molecular genetics into the diagnostic features RCCs. The most recent 2012 Vancouver classification recognized the newly established entities tubulocystic RCC, acquired cystic disease-associated RCC, clear cell (tubulo) papillary RCC, microphthalmia transcription factor family translocation RCC and hereditary leiomyomatosis RCC syndrome-associated RCC. In this article, the molecular and genetic properties of RCCs were summarized and the mechanisms underlying the development new entities of RCCs were discussed. The use of immunohistochemistry and molecular techniques were also evaluated in establishing an accurate diagnosis in new entities. [ABSTRACT FROM AUTHOR]

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