We investigated pre-operative factors for predicting pathological T3 (pT3) upstaging in clinical T1 renal cell carcinoma (RCC).
We evaluated 181 patients with renal tumors suspected to be clinical T1 RCC.
All patients had undergone a partial or radical nephrectomy. Pre-operative parameters, including patient characteristics, RENAL nephrometry score and blood tests were analyzed to determine factors predicting pT3 upstaging.
Eight (4.4%) tumors were diagnosed as pT3. Large tumor diameter, less than 4 mm distance between the tumor and the renal collecting system and a high level of preoperative plasma fibrinogen were associated with pT3 stage. Multivariate analysis showed that a preoperative plasma fibrinogen level >330 mg/dl was a significant independent factor predicting upstage (p=0.041). Furthermore, among patients diagnosed with RCC (n=162), a preoperative plasma fibrinogen level >330 mg/dl was related to poor overall survival (p<0.001) and poor recurrence-free survival (p=0.002).
A high preoperative plasma fibrinogen level may be a predictor of pT3 upstaging and may suggest the need for radical nephrectomy rather than partial nephrectomy because of the associated poor oncological outcomes.
Anticancer research. 2023 Oct [Epub]
Sho Sekito, Shiori Tanaka, Goshi Kitano, Manabu Kato, Yuji Ogura, Takahiro Kojima
Department of Urology, Aichi Cancer Center Hospital, Nagoya, Japan., Department of Urology, Aichi Cancer Center Hospital, Nagoya, Japan; .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/37648302