Renal capsular invasion (RCI) and lymphovascular invasion (LVI) are potential prognostic factors of significance in renal cell carcinoma (RCC). We evaluated the independent prognostic implications of RCI and LVI in localized clear cell RCC based on a large multi-institutional cohort. 6, 849 patients who had undergone radical or partial nephrectomy for RCC were included. Associations between recurrence and RCI or LVI were analyzed by constructing statistical models that combined Cox proportional hazard regression and propensity score matching. To analyze RCI, 2, 733 patients including 603 patients with RCI were enrolled. To analyze LVI, 3, 586 patients including 121 patients with LVI were enrolled. Recurrence was observed in 75 (12.4%) patients with RCI and 134 (6.3%) patients without RCI. In all statistical models, RCI was significantly associated with an increased risk of recurrence. Recurrence was observed 29 (24.0%) patients with LVI and 207 (6.0%) patients without LVI. LVI was significantly associated with an increased risk of recurrence only in non-adjusted univariate models, but not in multivariate adjusted analysis or propensity score matching models. In conclusion, these findings suggest that RCI could be a significant risk factor for localized clear cell RCC recurrence. In contrast to RCI, LVI cannot be an independent prognostic variable.
Scientific reports. 2018 Jan 09*** epublish ***
U-Syn Ha, Kyu Won Lee, Jin-Hyung Jung, Seok-Soo Byun, Cheol Kwak, Jinsoo Chung, Eu Chang Hwang, Yong-June Kim, Tae Gyun Kwon, Seok Ho Kang, Sung-Hoo Hong
Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea., Biostatistics, Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea., Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea., Department of Urology, Seoul National University College of Medicine, Seoul, Korea., Department of Urology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea., Department of Urology, Chonnam National University Medical School, Gwangju, Korea., Department of Urology, Chungbuk National University College of Medicine, Cheongju, Korea., Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea., Department of Urology, Korea University School of Medicine, Seoul, Korea. .