Histopathological evaluation of staging, grading and prognostic factors of renal cell carcinoma
Abstract
Introduction: Renal cell carcinoma (RCC) is a malignancy with an adverse prognosis for the majority of the patients. Renal cell carcinoma accounts for 80% to 85% of malignant kidney tumors. Despite that an increasing number of patients incidentally are diagnosed, still around 25–30% of patients with new diagnosed disease already have metastatic disease. Of the remaining patients with nonmetastatic disease, about 30–40% will progress with distant metastases or local recurrent RCC. Objective: To assess the prognosis of age, sex, race, tumor size, pathological staging, grading and prognostic factors of Renal Cell Carcinoma. Material and Methods: In the retrospective study was done in Department of Urology, Sir Salimullah Medical College, Mitford, Dhaka, Bangladesh from June 2021 to July 2022. A total number of 101 nephrectomy specimens were analyzed and 22 diagnosed cases of renal cell carcinoma were included in the study. The age and sex distribution of renal cell carcinomas diagnosed were study. Histopathological evaluation of renal cell carcinomas was carried out correlating with old records, histopathology slides, special stains and immunohistochemistry. Results: Total 101 nephrectomy specimens were analyzed and 22 diagnosed cases of renal cell carcinoma were included in the study. Maximum numbers of cases were seen in 40-49 years’ age group (31.8%) and also in 60-69 years’ age group (31.8%). Histological subtypes of renal cell carcinoma diagnosed were Clear cell type, papillary type, Chromophobe type and Collecting duct type. Maximum numbers of cases diagnosed were of Clear cell type renal cell carcinoma (59.09%). Least common subtype diagnosed was Collecting duct type renal cell carcinoma (4.5%). Least common subtype diagnosed was Collecting duct renal cell carcinoma (4.5%). Tumor size was >4cm in maximum number of cases i.e. 20 (72.8%). Most of the subtypes of renal cell carcinoma had Fuhrman nuclear grades 2 and 3. Out of 22 cases of renal cell carcinoma, sarcomatoid differentiation was observed histologically in 3 cases (13.6%) within the tumor tissue. 2 cases of Clear cell type and 1 case of papillary type of renal cell carcinoma had sarcomatoid differentiation. Conclusion: In concluded, the underscores the importance of nuclear grading in predicting survival of renal cell carcinoma patients. There is strong correlation between grade, tumor size, and stage. Nuclear grading is important in predicting survival of patients with renal cell carcinoma. Nuclear grading is strongly related to both tumor size and stage. Nuclear grading and staging of the histological subtypes strongly influences the survival of patients, as thus proven in this study.
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References
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