Urology Medical News about Capsular involvement, partial nephrectomy, renal cell carcinoma

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Capsular involvement in patients undergoing partial nephrectomy for localized renal cell carcinoma: an adverse pathological finding
BJU International, 08/14/09

Rouach Y et al. – In a trial to evaluate the prognostic impact of capsular involvement (CaI) in pts treated exclusively with partial nephrectomy (PN) for localized renal cell carcinoma (RCC), it was found that in a contemporary series of pts exclusively treated with PN for localized RCC, CaI was not predictive of disease recurrence and disease-specific mortality. These results do not support the use of any change in postoperative management in pts with CaI after PN.

Methods

Medical records were reviewed of pts treated with PN for a sporadic and localized RCC (pT1-pT2N0M0).
Univariate and multivariate analysis using a Cox proportional-hazards regression analysis were conducted to identify significant predictors of oncological outcome for several clinical and pathological factors, ie, imperative indication, histological type, Fuhrman grade, tumour size, T stage, CaI, and surgical margins.
Disease-free and -specific survival rates of pts with CaI and no evidence of CaI were compared using the log-rank test.

Results

305 pts had a PN for localized RCC, of whom 22 (7.2%) had CaI in the PN specimen.
Median (range) follow-up was 6 (1.5–23) yrs.
Multivariate statistical analysis showed that imperative indication for PN and high-grade RCC were independently associated with worse disease-free and -specific survival, whereas CaI had no prognostic value.
Disease-free and -specific survival in pts with and without CaI were not significantly different at 5 and 10 yrs.

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