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SHR Neuro Cancer Cardio Lipid

Becker, A; Hickmann, D; Hansen, J; Meyer, C; Rink, M; Schmid, M; Eichelberg, C; Strini, K; Chromecki, T; Jesche, J; Regier, M; Randazzo, M; Tilki, D; Ahyai, S; Dahlem, R; Fisch, M; Zigeuner, R; Chun, FK.
Critical analysis of a simplified Fuhrman grading scheme for prediction of cancer specific mortality in patients with clear cell renal cell carcinoma - Impact on prognosis.
Eur J Surg Oncol. 2016; 42(3):419-425
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Authors Med Uni Graz:
Chromecki Thomas
Jesche-Chromecki Johanna
Strini Karin
Zigeuner Richard
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Abstract:
The traditional 4-tiered Fuhrman grading system (FGS) is widely accepted as histopathological classification for clear cell renal cell carcinoma (ccRCC) and has shown prognostic value. As intra- and inter-observer agreement are sub-optimal, simplified 2- or 3-tiered FGSs have been proposed. We aimed to validate these simplified 2- or 3-tiered FGSs for prediction of cancer-specific mortality (CSM) in a large study population from 2 European tertiary care centers. We identified and followed-up 2415 patients with ccRCC who underwent radical or partial nephrectomy in 2 European tertiary care centers. Univariable and multivariable analyses and prognostic accuracy analyses were performed to evaluate the ability of several simplified FGSs (i.e. grades I + II vs., grades III + IV, grades I + II vs. grade III and grade IV) to predict CSM. Independent predictor status in multivariate analyses was proved for the simplified 2-tiered FGS (high-grade vs. low-grade), for the simplified 3-tiered FGS (grades I + II vs. grade III and grade IV) as well as for the traditional 4-tiered FGS. The prognostic accuracy of multivariable models of 77% was identical for all tested models. Prognostic accuracy of the model without FG was 75%. A simplified 2- or 3-tiered FGS could predict CSM as accurate as the traditional 4-tiered FGS in a large European study population. Application of new simplified 2- or 3-tiered FGS may reduce inter-observer-variability and facilitate clinical practice without compromising the ability to predict CSM in ccRCC patients after radical or partial nephrectomy. Copyright © 2015 Elsevier Ltd. All rights reserved.

Find related publications in this database (Keywords)
Cancer specific mortality
Clear cell renal cell carcinoma
Fuhrman grading
Nephrectomy
Survival
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