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| Content Provider | frontiers |
|---|---|
| Author | Guo, Pengju Wang, Yongxing Han, Yili Wei, Dechao Zhao, Jiahui Li, Mingchuan Jiang, Yongguang Luo, Yong |
| Abstract | Purpose: To identify the discrepancy of oncological outcomes for different pT3a renal tumor invasion patterns and pathological features. Methods: Relevant studies were identified by searching the PubMed, Cochrane library, Embase, and Web of Science. Cancer-specific survival (CSS) was selected as the endpoint. Pooled hazard ratio (HR) and 95% confidence interval (CI) extracted from multivariate cox models were evaluated to identify the hazard association. Results: A total of 22 studies enrolled 12384 patients were included for quantitative synthesis. Sinus fat invasion (SFI) + perinephric fat invasion (PFI) was associated with inferior CSS compared to SFI only (HR 1.97, 95% CI: 1.13-3.42, p=0.02). The comparable CSS was observed between SFI and PFI (HR 0.92, 95% CI: 0.69-1.23, p=0.57). SFI±PFI showed inferior CSS compared to PFI only (HR 1.81, 95% CI: 1.33-2.47, p=0.0002). The presence of pelvicalyceal system invasion significantly increased the risk of cancer-specific mortality (HR 1.91, 95% CI: 1.33-2.75, p=0.0005). Renal vein invasion (RVI) indicated poor oncological outcomes with respect to CSS (HR 1.45, 95% CI: 1.15-1.82, p=0.002). The concomitance of RVI and fat invasion (FI) significantly increased the risk of deterioration of CSS compared to RVI or FI (HR 2.13, 95% CI: 1.52-2.99, p7cm (HR 1.77, 95% CI: 1.46-2.15, p<0.0001) were the predictors of inferior CSS. The lymphovascular invasion (HR 1.11, 95% CI: 0.69-1.80, p=0.67) were indolent in terms of CSS. Conclusion: We identified the heterogeneous classification of pT3a renal tumor in the current TNM staging system and aggressive pathological features of CSS. A precise risk grade of CSS for different invasion patterns including comprehensive combinations may be useful for the further refinements of the TNM system. |
| ISSN | 2234943X |
| DOI | 10.3389/fonc.2021.678459 |
| Volume Number | 11 |
| Journal | Frontiers in Oncology |
| Language | English |
| Publisher Date | 2021-06-03 |
| Access Restriction | Open |
| Subject Keyword | Nephrectomy Cancer-specific survival PT3a Systematic review Renal tumor |
| Content Type | Text |
| Resource Type | Article |
| Subject | Cancer Research Oncology |
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