Renal cell carcinoma classification: Difference between revisions

	Renal cell carcinoma Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Renal cell carcinoma from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural history, Complications and Prognosis
Diagnosis
Staging
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Chest X Ray
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Renal cell carcinoma classification On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Renal cell carcinoma classification All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Renal cell carcinoma classification
CDC on Renal cell carcinoma classification
Renal cell carcinoma classification in the news
Blogs on Renal cell carcinoma classification
Directions to Hospitals Treating Renal cell carcinoma
Risk calculators and risk factors for Renal cell carcinoma classification

VisualWikitext

Revision as of 16:35, 27 December 2013

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Classification

Sporadic vs. Hereditary

The following tables classify renal cell carcinoma according to histologic appearance and differentiates sporadic from hereditary forms of renal cell carcinoma.

Sporadic Forms

**Sporadic Forms of Renal Cell Carcinoma^[1]**
Histologic Appearance	Incidence	Gene	Frequency
Conventional	75	VHL	60 %
Papillary	12	MET TFE3	13 % < 1 %
Chromophobe	4
Oncocytoma	4
Collecting Duct	< 1
Unclassified	3 - 5

^{Adapted from Cohen HT, McGovern FJ. Renal-cell carcinoma.N Engl J Med. 2005; 353:2477-90}

Hereditary Forms

**Hereditary Forms of Renal Cell Carcinoma^[1]**
Syndrome	Associated Gene	Common Histological Appearance
VHL Disease	VHL	Conventional
FCRC	Chromosome 3p translocation	Conventional
Hereditary Paraganglioma	SDHB	Conventional
HPRC	MET	Papillary
HLRCC	FH	Papillary
Birt-Hogg-Dube Syndrome	BHD	Chromophobe / Oncocytoma

^{Adapted from Cohen HT, McGovern FJ. Renal-cell carcinoma.N Engl J Med. 2005; 353:2477-90}

Staging

Clear cell renal carcinomas can be classified according to staging or anatomic spread of the disease. Two commonly implemented systems are the Modified Robson's System (1969) and the TNM (Tumor - Nodes - Metastasis) System:

Robson's System

The Modified Robson's staging system has been proposed in 1969. It emphasizes the anatomic distribution of the tumor and proximity to important vasculature and lymph nodes with prognostic implications, reporting a 52% 5-year survival and a 66% 5-year survival in patients with localized tumor.^[2]

**Robson's Classification System of Renal Cell Carcinoma Staging^[2]**
Stage	Definition
Stage I	Tumor confined within parenchyma
Stage II	Tumor involves perinephric fat, but still confined within Gerota's fascia
Stage III	A) Tumor involves main renal vein or vena cava B) Tumor involves regional lymph nodes C) Tumor involves both local vessels and lymph nodes
Stage IV	A) Tumor involves adjacent organs other than adrenal gland B) Distant metastasis

^{Adapted from Robson CJ, Churchill BM, Anderson W. The results of radical nephrectomy for renal cell carcinoma. J Urol. 1969; 101(3):297-301.}

References

↑ ^1.0 ^1.1 Cohen HT, McGovern FJ (2005). "Renal-cell carcinoma". N Engl J Med. 353 (23): 2477–90. doi:10.1056/NEJMra043172. PMID 16339096.
↑ ^2.0 ^2.1 Robson CJ, Churchill BM, Anderson W (1969). "The results of radical nephrectomy for renal cell carcinoma". J Urol. 101 (3): 297–301. PMID 5765875.

Template:WH Template:WS

[pmid16339096-1] 1.0 ^1.1 Cohen HT, McGovern FJ (2005). "Renal-cell carcinoma". N Engl J Med. 353 (23): 2477–90. doi:10.1056/NEJMra043172. PMID 16339096.

[pmid5765875-2] 2.0 ^2.1 Robson CJ, Churchill BM, Anderson W (1969). "The results of radical nephrectomy for renal cell carcinoma". J Urol. 101 (3): 297–301. PMID 5765875.

[1]

[2]

@@ Line 6: / Line 6: @@
 ===Sporadic vs. Hereditary===
 The following tables classify renal cell carcinoma according to histologic appearance and differentiates sporadic from hereditary forms of renal cell carcinoma.
+====Sporadic Forms====
 {| border="1" style="border-collapse:collapse; text-align:left;" cellpadding="5" align="center"
 |+ '''''Sporadic Forms of Renal Cell Carcinoma<ref name="pmid16339096">{{cite journal| author=Cohen HT, McGovern FJ| title=Renal-cell carcinoma. | journal=N Engl J Med | year= 2005 | volume= 353 | issue= 23 | pages= 2477-90 | pmid=16339096 | doi=10.1056/NEJMra043172 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16339096  }} </ref>'''''
@@ Line 24: / Line 25: @@
 <sup><center>Adapted from Cohen HT, McGovern FJ. Renal-cell carcinoma.''N Engl J Med''. 2005; 353:2477-90</center></sup>
+====Hereditary Forms====
 {| border="1" style="border-collapse:collapse; text-align:left;" cellpadding="5" align="center"
 |+ '''''Hereditary Forms of Renal Cell Carcinoma<ref name="pmid16339096">{{cite journal|author=Cohen HT, McGovern FJ| title=Renal-cell carcinoma. | journal=N Engl J Med |year= 2005 | volume= 353 | issue= 23 | pages= 2477-90 | pmid=16339096 |doi=10.1056/NEJMra043172 | pmc= |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16339096  }}</ref>'''''
@@ Line 45: / Line 46: @@
 <sup><center>Adapted from Cohen HT, McGovern FJ. Renal-cell carcinoma.''N Engl J Med''. 2005; 353:2477-90</center></sup>
+===Staging===
+Clear cell renal carcinomas can be classified according to staging or anatomic spread of the disease. Two commonly implemented systems are the Modified Robson's System (1969) and the TNM (Tumor - Nodes - Metastasis) System:
+====Robson's System====
+The Modified Robson's staging system has been proposed in 1969. It emphasizes the anatomic distribution of the tumor and proximity to important vasculature and lymph nodes with prognostic implications, reporting a 52% 5-year survival and a 66% 5-year survival in patients with localized tumor.<ref name="pmid5765875">{{cite journal| author=Robson CJ, Churchill BM, Anderson W| title=The results of radical nephrectomy for renal cell carcinoma. | journal=J Urol | year= 1969 | volume= 101 | issue= 3 | pages= 297-301 | pmid=5765875 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5765875  }} </ref>
+{| border="1" style="border-collapse:collapse; text-align:left;" cellpadding="5" align="center"
+|+ '''''Robson's Classification System of Renal Cell Carcinoma Staging<ref name="pmid5765875">{{cite journal| author=Robson CJ, Churchill BM, Anderson W| title=The results of radical nephrectomy for renal cell carcinoma. | journal=J Urol | year= 1969 | volume= 101 | issue= 3 | pages= 297-301 | pmid=5765875 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5765875  }} </ref>'''''
-* [[Clear cell carcinoma]] ([[Von Hippel-Lindau tumor suppressor|VHL]] and others on [[chromosome 3]])
+| bgcolor="#d9ff54"|'''Stage''' || bgcolor="#d9ff54"|'''Definition
-* [[Papillary]] carcinoma ([[C-Met|MET]], [[PRCC (gene)|PRCC]])
+|-
-* [[Chromophobe]] renal carcinoma
+| bgcolor="#ececec"|'''Stage I''' || Tumor confined within parenchyma
-* [[Collecting duct]] carcinoma
+|-
+| bgcolor="#ececec"|'''Stage II''' || Tumor involves perinephric fat, but still confined within Gerota's fascia
+|-
+| bgcolor="#ececec"|'''Stage III''' || A) Tumor involves main renal vein or vena cava
+<br> B) Tumor involves regional lymph nodes
+<br> C) Tumor involves both local vessels and lymph nodes
+|-
+| bgcolor="#ececec"|'''Stage IV''' || A) Tumor involves adjacent organs other than adrenal gland
+<br> B) Distant metastasis
+|}
+<sup><center>Adapted from Robson CJ, Churchill BM, Anderson W. The results of radical nephrectomy for renal cell carcinoma. ''J Urol''. 1969; 101(3):297-301.</center></sup>
 ==References==