Predictors of pathological upstaging in clinical stage T1 renal cell carcinoma include male gender, age, and irregular margins.
Photo by Aethrum / Unsplash
Key Takeaway
Recognize that male gender, age, and irregular margins are associated with higher risk of pathological upstaging in cT1 RCC.
This meta-analysis and systematic review assessed predictors of pathological upstaging in patients with clinical stage T1 (cT1) renal cell carcinoma. The analysis included 24,957 patients to determine factors associated with progression to pT3a disease. No specific setting or follow-up duration was reported for the included studies.
The overall incidence of pathological upstaging to pT3a was 7.46%. Several variables were identified as independent predictors of this outcome. Male gender was associated with an odds ratio (OR) of 1.067 (95% CI: 1.029–1.107; p=0.001). Advanced age showed an OR of 1.029 (95% CI: 1.02–1.038; p=0.0001), and a BMI of 1.016 (95% CI: 1.004–1.027; p=0.0001) per unit increase.
Clinically significant predictors included cT1b stage (OR: 5.865; 95% CI: 3.711–9.267; p=0.0001), presence of clinical symptoms (OR: 1.987; 95% CI: 1.439–2.744; p=0.0001), a RENAL score of 7-9 (OR: 2.480; 95% CI: 1.516–4.058; p=0.0001), necrosis on imaging (OR: 2.347; 95% CI: 1.570–3.509; p=0.0001), irregular margins (OR: 2.874; 95% CI: 1.760–4.693; p=0.0001), and hilus involvement (OR: 2.134; 95% CI: 1.367–3.333; p=0.001).
Regarding recurrence, unadjusted meta-analysis results indicated a hazard ratio (HR) of 3.50 (95% CI: 2.00–6.13). After multivariable adjustment, the HR was 2.60 (95% CI: 1.86–3.64). Safety data, adverse events, and tolerability were not reported. Limitations regarding study design and potential confounding factors were not detailed in the provided data. Current evidence suggests that nine variables, including advanced age, gender, and irregular margins, may be predictors of postoperative pathological upstaging of cT1 RCC.
More on Renal Cell Carcinoma
Narrative review suggests adjuvant pembrolizumab benefits selected high-risk renal cell carcinoma patients.
Old cancer drugs failed, but one new drug saves high-risk kidney patients today.
This narrative review evaluates adjuvant therapies for renal cell carcinoma, including cytokine-based immunotherapy, VEGF-targeted agents, a…
Doctors finally have a powerful new tool to stop kidney cancer from coming back after surgery, but it only works for specific patients.
Open-sourcing data and annotations for renal cell carcinoma yielded 142 annotated CT scans from 101 patients.
Open-source CT scans aim to boost kidney cancer AI research
This cohort study involved 101 patients with renal cell carcinoma (RCC) and analyzed 142 annotated CT scans. After quality control, the data…
Researchers release 142 annotated CT scans from 101 kidney cancer patients to accelerate AI development.
Targeted therapy versus non-targeted therapy in renal cell carcinoma patients.
Real-world study in Taiwan shows targeted therapy offers similar life expectancy for advanced kidney cancer compared to non-targeted therapy.
This real-world cohort study analyzed 14,131 renal cell carcinoma cases in Taiwan from 1998 to 2016. Patients receiving targeted therapy sho…
In Taiwan, targeted therapy for advanced kidney cancer offers similar life expectancy to non-targeted therapy, with both groups living aroun…
CD8 PET imaging shows modest correlation with biopsy CD8 counts in solid tumor patients on immunotherapy
New imaging method shows modest link to immune cell counts in solid tumors
A Phase II prospective multicenter study of 49 patients with solid tumors receiving immune checkpoint blockade found a modest correlation (c…
A new PET scan shows a modest link to immune cell counts inside solid tumors, with stronger results in kidney cancer patients.
View Original Abstract ↓
BackgroundThe potential predictors and clinical implications of postoperative pathological upstaging in patients with clinical stage T1 (cT1) renal cell carcinoma (RCC) remain insufficiently characterized.MethodsThis systematic review was performed in accordance with the PRISMA guidelines. Databases including PubMed, Web of Science and Embase databases were searched. A total of 17 studies (involving 24957 patients) were included, and relevant factors were analyzed from the perspectives of patients’ baseline characteristics, pathology, and imaging findings.ResultA total of 17 studies involving 24,957 patients were included. The overall incidence of pathological upstaging was 7.46%. Through combined qualitative and quantitative analysis, we identified the following independent risk associated factors for pathological upstaging to pT3a: male gender (OR: 1.067; 95% CI: 1.029–1.107;p=0.001), age (OR = 1.029; 95% CI: 1.02–1.038;p = 0.0001), BMI (OR:1.016;95% CI: 1.004–1.027;p=0.0001),cT1b (OR: 5.865; 95% CI: 3.711- 9.267; p = 0.0001),presence of clinical symptoms(OR:1.987; 95% CI: 1.439- 2.744; p = 0.0001), RENAL score= 7-9 (OR = 2.480; 95% CI: 1.516–4.058;p = 0.0001),necrosis on imaging(OR = 2.347;95% CI: 1.570–3.509;p = 0.0001), irregular margins (OR = 2.874; 95% CI: 1.760–4.693;p = 0.0001)and Hilus involvement (OR = 2.134;95%CI: 1.367-3.333;p = 0.001).Furthermore, the unadjusted meta-analysis results indicated an increased risk of recurrence in patients who upstaged to pT3a (HR = 3.50,95% CI = 2.00-6.13). After multivariable adjustment, the association remained consistent and in the same direction (HR = 2.60,95% CI = 1.86-3.64).ConclusionCurrent evidence suggests that 9 variables, including advanced age, gender, and irregular margins may be predictors of postoperative pathological upstaging of cT1 RCC.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD420250640397.
Digital and AI-supported psychosocial interventions modestly reduce distress and improve quality of life in women with breast cancer.
Digital mental health tools may help breast cancer patients feel better
Related in Oncology
Meta-analysis finds frozen section reliable for tumor-free margins in OSCC
Surgeons rely on frozen sections to ensure clean cuts for oral cancer patients
This systematic review and meta-analysis of 19 studies (9 with complete data) assessed frozen section analysis for detecting tumor-free marg…
A new review confirms that frozen section analysis is a highly reliable way for surgeons to check if oral cancer has been fully removed duri…
Meta-analysis: Temporary uterine artery ligation reduces blood loss in myomectomy
Temporary uterine artery ligation reduces blood loss during fibroid surgery
This systematic review and meta-analysis of 857 women found that adding temporary uterine artery ligation (TUAL) to laparoscopic myomectomy …
A meta-analysis of 857 women found that adding temporary uterine artery ligation to fibroid surgery reduced blood loss and hemoglobin drop.
Lenvatinib plus PD-1 inhibitor improves survival versus bevacizumab plus PD-1 inhibitor in unresectable hepatocellular carcinoma
Meta-analysis shows lenvatinib-based regimens improve survival for unresectable liver cancer in East Asia
This systematic review and meta-analysis evaluated first-line treatment for unresectable hepatocellular carcinoma in East Asian populations.…
A meta-analysis of East Asian patients with unresectable liver cancer found lenvatinib-based regimens improved survival compared to bevacizu…
Systematic review and meta-analysis identifies factors influencing quality of life in colorectal cancer survivors
Social support and resilience boost quality of life for colorectal cancer survivors
This systematic review and meta-analysis synthesizes evidence on factors affecting quality of life in colorectal cancer survivors. Fatigue, …
A meta-analysis found that social support, resilience, and self-efficacy are linked to better quality of life in colorectal cancer survivors…
From Other Specialties
Meta-analysis links baseline and dynamic ctDNA to survival in advanced NSCLC
ctDNA in blood predicts survival in advanced lung cancer
This systematic review and meta-analysis of 43 studies found that detectable or elevated baseline plasma ctDNA was associated with worse ove…
A blood test for tumor DNA can predict survival in advanced lung cancer, helping guide treatment decisions.
Meta-analysis shows platinum-etoposide plus PD-1/PD-L1 inhibitor improves survival in extensive-stage small-cell lung cancer
Adding PD-1 or PD-L1 inhibitors improves survival for extensive-stage small-cell lung cancer
This meta-analysis of phase III trials evaluated platinum-etoposide combined with a PD-1 or PD-L1 inhibitor versus platinum-etoposide alone …
Adding a PD-1 or PD-L1 inhibitor to standard chemotherapy improves survival for extensive-stage small-cell lung cancer without increasing se…
Systematic review and meta-analysis shows immune checkpoint inhibitors improve survival in first-line ES-SCLC but not as single agents in second-line
Immune drugs boost survival in small-cell lung cancer
This systematic review and meta-analysis evaluates immune checkpoint inhibitors combined with chemotherapy versus chemotherapy alone for ext…
Adding immune checkpoint inhibitors to chemotherapy helps patients with extensive-stage small-cell lung cancer live longer.
Network meta-analysis of anti-PD-1/PD-L1 regimens in advanced non-squamous NSCLC without EGFR or ALK alterations
New drugs beat old ones for advanced lung cancer survival
This systematic review and network meta-analysis evaluated overall survival and progression-free survival across 15 Phase III randomized cli…
New drug combinations show better survival chances for advanced lung cancer patients whether their tumors express PD-L1 or not