IV CONGRESO VIRTUAL HISPANO AMERICANO DE ANATOMÍA PATOLÓGICA |
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INTRODUCTION | ||
An international consensus conference reviewed the current state of histologic classification of renal cell carcinoma, the grading, TNM staging, current and future prognostic factors, and clinical research priorities. This conference held at Rochester, Minnesota, USA, on March 21-22, 1997 was called "The First International Workshop on Renal Cell Carcinoma" and was coordinated by the World Health Organization in collaboration with the Union International Contre le Cancer (UICC), American Joint Committee on Cancer (AJCC), Mayo Clinic and Mayo Foundation, the Pacific Northwest Cancer Foundation (1-9) . International agreement was reached on the histologic classification of Renal Cortical Epithelial Neoplasms (RCEN) as following:
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MATERIAL Y METHODS | ||
Larpac Laboratory received 48,874 surgical specimens between January 1978 and March 2000, and from these, all the renal tumors were analyzed retrospectively. A total of 137 cases (0.28%) of primary kidney neoplasms were diagnosed. Ninety of which were renal cortical epithelial neoplasms (RCEN). The "1997 Rochester/Minnesota Renal Cell Carcinoma Classification" on RCEN, TNM staging and Fuhrman's grading system were used in this review of slides using HE staining and Hale's colloidal iron staining. A retrospective clinical correlation of 122 primary kidney neoplasms was performed by the Institute of Urology and Nephrology (IUN). The study of these tumors was separated in Non-RCEN and RCEN, as well in Benign and Malignant Neoplasms, as following:
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RESULTS | ||
The following primary renal neoplasms were diagnosed: Collecting Duct Carcinoma (CDC) one case (0.74%), Leiomyosarcoma two cases (1.46%), Cystic Nephroma two cases (1.46%), Sarcoma two cases (1.46%), Unclassified Carcinoma two cases (1.46%), Oncocytoma three cases (2.19%), Angiomyolipoma nine case (6.57%), Wilms' Tumor eleven cases (8.03%), Transitional Cell Carcinoma 21 cases (15.33%) and Renal Cell Carcinoma (RCC) 84 cases (61.31%) (Graphic 1). Using the "1997 Rochester/Minnesota Renal Cell Carcinoma Classification", 90 RCEN cases were reviewed and the following data was found: one Collecting Duct Carcinoma, two Unclassified Carcinoma, three Oncocytoma and 84 Renal Cell Carcinoma (Graphic 11). The association between clinical information and histopathological report showed: 1 - Non-Renal Cortical Epithelial Neoplasms (Non-RCEN): Benign Neoplasms
2 - Non-Renal Cortical Epithelial Neoplasms (Non-RCEN): Malignant Neoplasms
3 - Renal Cortical Epithelial Neoplasms (RCEN): Benign Neoplasms
4 - Renal Cortical Epithelial Neoplasms (RCEN): Malignant Neoplasms
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CONCLUSION | |
Brazilian papers in relation to primary renal tumors as well as to the "1997 Rochester/Minnesota Renal Cell Carcinoma Classification" on renal cortical epithelial neoplasms (RCEN), are scarce. This paper is a contribution to the Brazilian clinical and pathological data on this issue. Some disagreements between this regional Brazilian study and others were observed. It is probably due to the heterogeneous mixture of races that exists in Brazil. There were some differences in the evolution of the renal cell carcinoma subtypes: 0% of the chromophobe type, 5.26% of the papillary type and 21.57% of the conventional type evolved to death. The two first types of RCC showed a better prognosis than the last one. Therefore, this report may substantiate the concept that the subtypes of renal cell carcinoma are probably distinct biological entities.
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ACKNOWLEDGEMENTS |
Our thanks to Dr. Reynaldo Azoubel, from FAMERP, S.J.R.P., SP, Brazil, for the encouragement concern our renal tumors papers.
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| CORRESPONDENCE |
Correspondencia: Sueli Suzigan. Larpac Laboratory, São José do Rio Preto, SP, Brazil larpac@riopreto.com.br
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REFERENCES | ||
2. Bostwick DG, Eble JN, Murphy GP: Conference summary: diagnosis and prognosis of renal cell carcinoma: 1997 Workshop, Rochester, Minnesota, March 21-22, 1997, Cancer 80: 975-976, 1997. 3. Bostwick DG, Murphy GP: Diagnosis and prognosis of renal cell carcinoma: highlights from an international consensus workshop, Seminars in Urologic Oncology 16(1): 46-52, 1998. 4. Bostwick DG, Eble JN: Diagnosis and classification of renal cell carcinoma, Urologic Clinics of North America 26(3): 627-635, 1999. 5. Delahunt B, Eble JN: Renal tumours: the new order, New Zealand Medical J 111: 307-309, 1998. 6. Guinan P, Sobin LH, Algaba F, Badellino F, Kameyama S, MacLennan G, Novick A: TNM staging of renal cell carcinoma: Workgroup n°. 3, Cancer 80: 992-993, 1997. 7. Medeiros LJ, Jones EC, Aizawa S, Aldape HC, Cheville JC, Goldstein NS, Lubensky IA, Ro J, Shanks J, Pacelli A, Jung S-H: Grading of renal cell carcinoma: Workgroup n° 2, Cancer 80: 990-991, 1997. 8. Srigley JR, Hutter RVP, Gelb AB et al: Current prognostic factors - renal cell carcinoma: Workgroup n° 4, Cancer 80: 994-996, 1997. 9. Störkel S, Eble JN, Adlakha K, Amin M, Blute ML, Bostwick DG, Darson M, Delahunt B, Iczkowski K: Classification of renal cell Carcinoma: workgroup n° 1: Union Internationale Contre le Cancer (UICC) and the American Joint Committee on Cancer (AJCC), Cancer 80(5): 987-989, 1997. |