Renal cell carcinoma and pathologic nodal disease: Implications for American Joint Committee on Cancer staging

Abstract

Background: Lymph node (LN) metastases are associated with poor outcomes for patients with renal cell carcinoma (RCC). This study compared the survival outcomes of patients with stage III, node-positive disease (pT123N1M0) and patients with stage III, node-negative disease (pT3N0M0). Methods: A database of 4652 patients with RCC of any histological subtype treated with surgery at The University of Texas MD Anderson Cancer Center from 1993 to 2012 was retrospectively assessed. A total of 115 patients with pT123N1M0 disease, 274 patients with pT3N0M0 disease, and 523 patients with pT123N0/xM1 disease were included. Overall survival (OS) and cancer-specific survival (CSS) were estimated and compared between each cohort. Results: Median OS and CSS times were significantly better for pT3N0M0 patients than pT123N1M0 patients (OS, 10.2 vs 2.4 years, P