The Effect of Tumor Size on Oncologic Outcomes in Pathological T2 Stage Renal Cell Carcinoma Patients

Objective: To evaluate the oncologic outcomes in T2 stage renal cell carcinoma (RCC) patients who underwent open radical nephrectomy and the effect of patient’s tumor size on the oncologic outcomes. Materials and Methods: Data of patients who underwent open radical nephrectomy due to pre-diagnostic RCC between January 2010 and January 2014 and had the tumor size >7 cm were retrospectively evaluated. Two hundred thirty six patients with final pathologic diagnosis of RCC were included in the study. Patients were divided into two groups according to their tumor sizes (≤10 cm and >10 cm). The data of demographics, histological tumor subtype, tumor grade, survival after nephrectomy, local recurrence and metastasis were recorded. Results: Mean age and mean tumor size of patients at diagnosis were 58±11.5 years (28-80) and 10.4±2.6 cm (7.1-20), respectively. Out of 236 patients included in the study tumor size were ≤10 cm (group 1) in 120 patients and >10 cm (group 2) in 116 patients. After median 36 (16-176) months follow up time, local recurrence, distant metastasis, disease specific survival and overall survival rates of the patients were 19.4%, 7.6%, 82.6% and 77.6%, respectively. When the two groups were compared; patients in group 1 were determined to have significantly higher disease specific survival (89% vs. 75%, p=0.007), higher overall survival rate (86% vs. 81%, p=0.001), lower local recurrence rate (13% vs. 25%, p=0.023) and lower local distant metastasis rates (5% vs. 12%, p=0.01). Conclusion: In patients whose tumor sizes are larger than 10 cm, lower disease specific survival and overall survival, higher local recurrence and distant metastasis rates were observed. Therefore, those patients should be followed more carefully after nephrectomy