Correlation between size of renal cell carcinoma and its grade, stage, and histological subtype

The aim of this study was to determine the correlation between histological subtype, size, grade, and stage of the kidney tumors and to investigate whether a correlation exists between the size of the kidney tumor and its behavior. Between 1996 and 2004, we had 212 patients with radical or partial nephrectomy due to a kidney tumor at Shaheed Labbafmejad Medical Center. Their pathologic blocks were re-evaluated with consideration of their tumor size and pathologic features. Of 212 pathologic blocks, 17 [8%] were benign and 195 [92%] were malignant masses including 179 renal cell carcinoma [RCC] tumors. Malignant tumors were slightly greater compared with the benign ones [P = .10]. There was no significant relation between the size of tumor and the histological subtype. Significant relations between the size of the kidney tumor and the nuclear grade [P = .007], clinical symptoms [P = .02], and extracapsular extension [P < .001] were observed. In smaller RCC tumors [< 4 cm], extracapsular extension [stages T3 and T4] was rare [1 in 29]. However, smaller RCC tumors were not significantly different from those larger than 4 cm regarding the nuclear grade, symptoms, and histological subtypes. Tumor size is not an independent predictor for the histological subtype of the tumors; however, larger malignant tumors may have higher grades, higher stages, and clinical symptoms

Prediction of prostatic involvement by transitional cell carcinoma of the bladder using pathologic characteristics of the bladder tumor

The aim of this prospective study is to determine the relationship between the pathologic characteristics of the transitional cell carcinoma [TCC] of the bladder and prostatic involvement. Sixty men with bladder TCC underwent standard radical cystoprostatectomy and were enrolled in this study. Vascular and perineural invasion, maximum diameter of the tumor, presence of carcinoma in situ, distance between the tumor and the bladder neck, and grade and local stage of the tumor were recorded and their relation with prostatic involvement was studied. In addition, hydronephrosis and age of the patients were included in the analysis. The mean age of the patients was 63.9 +/- 11.1 years. Of 60 men included in this study, 15 patients were found to have prostatic involvement with TCC [25%]. Univariate statistical analyses showed that vascular invasion and the distance between the tumor and the bladder neck were significantly related to the prostatic involvement [P = .007; P < .001]. But, in the logistic regression, only the distance between the tumor and the bladder neck was significantly related to the prostatic involvement [P = .001]. This study suggests that the probability of prostatic involvement in patients with bladder TCC tumors near the bladder neck is high. Prostate-sparing or capsule-sparing cystectomy should be avoided in such patients