502 INDEPENDENT VALIDATION OF THE 2009 AMERICAN JOINT COMMITTEE ON CANCER TNM CLASSIFICATION FOR RENAL CELL CARCINOMA USING A LARGE, SINGLE INSTITUTION COHORT

You have accessJournal of UrologyKidney Cancer: Evaluation and Staging I1 Apr 2010502 INDEPENDENT VALIDATION OF THE 2009 AMERICAN JOINT COMMITTEE ON CANCER TNM CLASSIFICATION FOR RENAL CELL CARCINOMA USING A LARGE, SINGLE INSTITUTION COHORT Angela Alt, Michael Blute, Igor Frank, John Cheville, and Allmer Cristine Angela AltAngela Alt More articles by this author , Michael BluteMichael Blute More articles by this author , Igor FrankIgor Frank More articles by this author , John ChevilleJohn Cheville More articles by this author , and Allmer CristineAllmer Cristine More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.578AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The TNM classification for renal cell carcinoma (RCC) was updated by the American Joint Committee on Cancer in 2009. In the current study we evaluated the 2009 classification and compared its predictive ability to the 2002 classification. METHODS We studied 3,996 patients treated with radical nephrectomy or nephron sparing surgery for unilateral or bilateral synchronous RCC between 1976 and 2006. Cancer specific survival (CSS) was estimated using the Kaplan-Meier method. The predictive abilities of the 2002 and 2009 classifications were compared using concordance indexes. RESULTS There were 1165 deaths from RCC at a median of 1.9 years. Median follow up for patients alive at last follow up was 7.4 years. Estimated 10 year CSS rates by the 2009 primary tumor classification were 96%, 80%, 66%, 55%, 36%, 26%, 25%, and 12% for 2009 pT1a, pT1b, pT2a, pT2b, pT3a, pT3b, pT3c, and pT4 patients, respectively (p<0.001). The concordance indexes for the 2002 and 2009 TNM classifications were 0.848 and 0.850, respectively. CONCLUSIONS Our data suggest that the 2009 classification with pT2 lesions divided into pT2a and pT2b, ipsilateral adrenal involvement reclassified as pT4, renal vein involvement reclassified as pT3a, and nodal involvement simplified to N0 versus N1 resulted in a modest improvement in predictive ability compared to the 2002 classification. Rochester, MN© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e198 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Angela Alt More articles by this author Michael Blute More articles by this author Igor Frank More articles by this author John Cheville More articles by this author Allmer Cristine More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...