Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P52742 (pT3)
 1,034 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To clarify the recent clinical characteristics of renal cell carcinomas and to evaluate possible determinants for metastasis and venous tumor thrombi, the authors reviewed data from 99 renal cell carcinoma patients treated at Nagoya University Hospital between 1980 and 1989. According to Robson's classification, stage I tumors were found in 48 patients, stage II in 9, stage III in 16, and stage IV in 26. Incidentally detected tumors appeared to be on the increase in recent years. Grade 1 tumors were significantly associated with low-stage tumors and expansive growth. Univariate and multivariate analyses using a logistic regression model demonstrated that venous tumor thrombi and histological grade were significantly related to distant metastasis. Univariate analysis revealed relative risks of 4.7 for venous tumor thrombus presence (pV1b-pV2 vs. pV0-pV1a, p = 0.005) and 8.5 for histological grade (grades 2 and 3 vs. grade 1, p = 0.04). Local invasion (pT3 vs. pT2a-pTb: a relative risk of 7.5, p = 0.0009) and infiltration pattern (INF beta and INF gamma vs. INF alpha: a relative risk of 11.5, p = 0.002). were associated with venous tumor thrombi. Local invasion (pT3 vs. pT2a-pT2b: a relative risk of 6.6, p = 0.03) was the only significant determinant for lymph node metastasis. The 5-year actuarial survival rate was 60.0% for all 99 patients. The 5-year survival rates for stage I and II tumors were, respectively, 91.8% and 64.8%.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical characteristics and prognosis of renal cell carcinoma. Statistical evaluation of possible determinants for distant metastasis, venous tumor thrombi, and lymph node metastasis]. 156 35

Lymphocyte subsets were examined in renal cell carcinoma (TILs), adjacent non-tumor renal tissue and peripheral blood (PBLs) by flow cytometry and histochemistry in eighteen patients with renal cell carcinoma. CD5-positive cells were predominant in the TILs in 14 patients. In the renal cell carcinoma tissue, CD8-positive cells were predominant over CD4-positive cells, resulting in a less than unity ratio of CD4/CF8-positive cells. The lymphocyte number was significantly in adjacent normal renal tissue than in renal cell carcinoma. However, lymphocyte subsets ratios were not significantly different between these two tissues. PBLs showed the same proportions (CD4/CD8 mean 1.9 +/- 0.8) as the previously published healthy controlled data. The proportions of CD8-positive cells were significantly increased (p less than 0.05) and those of CD4-positive cells were also significantly decreased (p less than 0.01) in the TILs. The infiltrating pattern of TILs in 17 patients was divided histochemically into cluster (N = 7), single (N = 4), and mixed types (N = 6). The cluster and mixed types were significantly more common in grade 1 tumors and the single type was more common in the grade 2 tumors (p less than 0.05). The pT3 tumors showed the single type of TIL infiltration pattern, but showed no significant difference. In the cluster pattern of TILs, CD8-positive cells were surrounded by CD4-positive cells. Non-tumorous kidneys showed no infiltration of lymphocytes, except in 2 patients of pyelonephritis. These results suggest that cytotoxic T-cells stained as CD8 play an immunoreactive role against renal cell carcinoma.
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PMID:[Lymphocytic subsets of tumor tissue, non tumorous kidney, and the peripheral blood in primary renal cell carcinoma]. 176 68

Ninety-one consecutive patients with renal cell carcinoma stages pT1-4/N0-3/V0-2/M0 were analyzed for survival rates. The overall 5-year survival was 57%. Factors which made an impact on 5-year survival rates were: (1) grade of anaplasia (GI: 72%, GII: 42%, GIII: 22%; p = 0.0001); (2) pathological stage (pT1-2: 86%, pT3: 30%; p = 0.0000); (3) perinephric fat invasion (pT1-2: 86%, pT3a: 61%; p = 0.01); (4) nodal involvement (N0: 69%, N1: 11%; p = 0.0000), and (5) venous invasion (V0: 72%, V1-2: 30%; p less than 0.01). There were no differences in survival rates between V1 and V2 tumors (p greater than 0.05). Using multivariate statistical analysis we found that grade of anaplasia and venous invasion contained dire prognostic information (p = 0.0000). Among patients with stage pT3b, those without perinephric fat invasion or nodal involvement had a better survival rate than those with capsular infiltration (p less than 0.01) and a significantly better rate than those with perinephric fat invasion and nodal involvement (p less than 0.01). Moreover, there were no differences between stages pT3b with venous invasion only and stages pT1-2 (p greater than 0.05). Patients with venous invasion developed distant metastases with a significantly higher frequency than those without (p = 0.01). The prognostic impact of venous invasion is unclear yet, but is probably related to perinephric fat invasion and nodal involvement. Until further data are collected, the radical approach with complete removal of the thrombus remains the treatment of choice for localized renal cell carcinoma with vena caval extension.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Renal cell carcinoma: vena caval invasion and prognostic factors. 191 34

Ninety-nine consecutive patients with renal cell carcinoma in stages pT1-4/N0-3/V0-2/M0 were analyzed. Overall 5 year survival was 61%. Factors with greater impact on survival were: 1) degree of anaplasia (DI 73%, DII 47%, DIII 27%; p = 0.0005), 2) pathological stage (pT1-2 87%, pT3 39%; p = 0.0000), 3) perirenal fat invasion (pT1-2 87%, pT3a 60%; p = 0.007), 4) node status (N0 72%, N1-3 17%; p = 0.0000) and 5) veins invasion (V0 74%, V1-2 35%; p = 0.005). No difference in survival between V1 and V2 (40% vs 33%; p0.05) tumours was found. A multivariable study showed that the degree of anaplasia and veins invasion have a significant and separate influence on survival (p = 0.0000). Among patients with vascular invasion, those with no perirenal fat invasion or node damage show better survival rates than patients with capsular infiltration (62% vs 40%; p) and perform significantly better than patients with capsular invasion and nodal implication (62% vs 30%; p). No survival differences were observed between pT3b stages with venous invasion only and pT1-2 stages (p0.05). Venous invasion is not in itself of prognostic relevance; the prognostic significance of vascular invasion is directly related to the presence of perirenal fat invasion and/or nodal implication.
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PMID:[Survival analysis in renal cell carcinoma with invasion of the vena cava]. 192 44

Since the addition of ultrasonography and computerized tomography to the diagnostic tools used for the recognition of renal tumor masses, detection of renal cell carcinomas has been much earlier and more reliable than formerly. Between July 1981 and June 1990, 335 patients without distal metastases underwent radical nephrectomy for renal cell carcinoma. In only 2.6% of the patients were adrenal metastases found, exclusively with stage pT3 tumors. The results of this review suggest that the adrenal gland need not be removed with the radical nephrectomy specimen in the case of tumors staged T1 or T2 if the adrenal CT scan is normal.
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PMID:[Is adrenalectomy always advisable in tumor nephrectomy?]. 194 46

Prognostic factors were studied in 91 patients with diagnosed renal adenocarcinoma in stages pT1-4/N0-3/V0-2/M0. All patients had been treated with radical surgery, extended nephrectomy with or without cardiopulmonary by-pass and extracorporeal circulation in those cases with suprahepatic tumoral thrombosis. The tumoral features which have a significant incidence on the patient's survival rate are the degree of cellular anaplasia, GI 72% vs GII 42% vs GIII 22% (p less than 0.0001); pathological stage, pT1-2 86% vs pT3 30% (p = 0.0000), perirenal fat invasion, pT1-2 86% vs pT3a 61% (p = 0.01); renal vein or cava vein invasion, V0 72% vs V1-2 30% (p less than 0.01) and gangliar affection. N0 69% vs N1-3 11% (p = 0.0000). Development of systemic disease is significantly high in pT3 stages (p = 0.0001), mainly in pT3a (p = 0.01), N1-3 (p less than 0.05) and/or V1-2 (p = 0.01). There is premature development of metastasis conditioning death before the second year o study in 90% of patients. In our opinion, patients with renal adenocarcinoma in stages pT3a/N0/M0, pT3b/N0/M0 and pT2-4/N1-3/M0 present a high potential risk of developing metastatic disease following radical surgery. These patients, as well as those with high degree tumours and presumably minimum residual disease, are candidates for supplementary therapy with lymphokine immunotherapy (rIL-2,FNT, alpha or gamma IF, etc) with or without adoptive cellular immunotherapy (LAK or TIL) following radical surgery, and extended nephrectomy plus tumoral thrombectomy, if required, with or without cardiopulmonary bypass.
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PMID:[Neoadjuvant immunotherapy in non-metastatic renal adenocarcinoma]. 208 Jul 25

The predictive strengths of the third and new fourth editions of the tumor, nodes and metastasis classification are compared using 872 cases of operatively treated renal cell carcinoma. The new tumor, nodes and metastasis classification facilitates an improved assessment of prognosis by subdivision of the former category pT3 into pT3a and pT3b. The new pN classification permits recognition of an especially unfavorable subgroup (pN3) in patients with regional lymph node metastases. The new stage grouping makes a rough subdivision of patients into groups with different prognoses. However, stages 1 and 2 show similar survival rates. Compared to the commonly used Robson stages, the International Union Against Cancer stage grouping has advantages as well as disadvantages. Any resulting recommendations for modification of stages should be subject to testing by other institutions.
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PMID:Evaluation of the new tumor, nodes and metastases classification of renal cell carcinoma. 237 85

Our experience of radical nephrectomy was analyzed and recent management of renal cell carcinoma was reviewed. One hundred forty-eight patients with renal cell carcinoma were treated by radical nephrectomy between 1970 and December, 1986. The 5-year survival rate according to pathological T-stage was 100% for 4 patients in pT1, 73% for 85 patients in pT2, 51% for 54 patients in pT3, and 0% for 5 patients in pT4. Four patients in pT1 had no venous involvement, lymph node metastasis, or distant metastasis. Thirty patients had venous involvement, 8 in pT2, 20 in pT3 and 2 in pT4. Seventeen patients had positive lymph nodes, 0 in pT2, 15 in pT3 and 2 in pT4. Thirty-three patients had distant metastasis at the time of nephrectomy, 12 in pT2, 18 in pT3 and 3 in pT4. The 5-year survival rates of 30 patients with venous involvement, 17 with lymph node metastasis and 33 with distant metastasis were 47%, 30% and 37%, respectively. No anti-cancer drugs have been recognized to be effective for renal cell carcinoma. However, recent experiences with interferon and lymphokine-activated killer cell therapy suggest that immunotherapy may have a potential role in the management of metastatic renal cell carcinoma.
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PMID:[Recent management of renal cell carcinoma]. 325 77

One hundred and six patients with renal cell carcinoma were treated with radical nephrectomy at our Department between 1970 to December, 1985. A retrospective analysis was performed with TNM staging system of The General Rule for Clinical and Pathological Studies on Renal Cell Carcinoma, which was established by the Japanese Urological Association in 1983. The 5-year survival rate according to pathological T-stage was 100% for 2 patients in pT1, 67.5% for 58 patients in pT2, 49.5% for 42 patients in pT3, 0% for 4 patients in pT4. Two patients in stage of pT1 had no venous involvement, lymph node metastasis, or distant metastasis. Twenty two patients had positive venous involvement (21%), 4 (7%) in stage of pT2, 16 (38%) in pT3, 2 (50%) in pT4. Twelve patients had positive lymph nodes (11%), 0 (0%) in stage of pT2, 10 (24%) in pT3, 2 (50%) in pT4. Twenty five patients, (24%) had distant metastasis at the time of nephrectomy, 8 (14%) in stage of pT2, 15 (38%) in pT3, 2 (50%) in pT4. The 5-year survival of 22 patients with venous involvement, 12 patients with lymph nodes metastasis, 25 patients with distant metastasis were 47%, 30%, 39% respectively. No significant difference of 5-year survival between 69% of 48 patients in T1 & 2VoNoMo (Robson-I) and 76% of 12 patients in T3VoNoMo (Robson-II) were considered to need the establishment of new classification for early stage of renal cell carcinoma. TNM staging system was thought to be better than Robson's Classification for analyzing the unique biological potential of renal cell carcinoma.
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PMID:[Results of radical nephrectomy for renal cell carcinoma. Report 1. Analysis according to the TNM staging system of the general rule for clinical and pathological studies on renal cell carcinoma]. 361 1

The benefit of low-dose preoperative radiotherapy in hypernephroma has not been proven in phase-II studies. Medium-dose preoperative radiotherapy many transform inoperable to operable tumors in numerous cases. In a randomized study, no prolongation of survival has been found, however. Many retrospective studies, in part with questionable design, have found no value of routinely used postoperative irradiation. Presently, it is indicated in advanced local tumor stages (pT3 and pT4) and residual tumors. Postoperative radiotherapy in high-risk patients using defined techniques and preoperative radiotherapy applying modern diagnostic equipment for treatment planning remains to be evaluated. For palliation, radiotherapy is useful treating brain-, lung- and bone metastases and inoperable primary tumors.
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PMID:[Radiotherapy of kidney cancer]. 396 42


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