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Trends of stage, grade, histology and tumour necrosis in renal cell carcinoma in a European centre surgical series from 1984 to 2010
  1. Martin Pichler1,
  2. Georg C Hutterer2,
  3. Thomas F Chromecki2,
  4. Johanna Jesche2,
  5. Karin Kampel-Kettner2,
  6. Katharina Eberhard3,
  7. Gerald Hoefler4,
  8. Karl Pummer2,
  9. Richard Zigeuner2
  1. 1Division of Oncology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria
  2. 2Department of Urology, Medical University of Graz, Graz, Austria
  3. 3Research Facility for Biostatistics, Medical University of Graz (MUG), Graz, Austria
  4. 4Institute of Pathology, Medical University of Graz, Graz, Austria
  1. Correspondence to Dr Martin Pichler, Medical University of Graz (MUG), Division of Oncology, Auenbruggerplatz 15, Graz A-8010, Austria; martin.pichler{at}


Aims To analyse renal cell carcinoma (RCC) stage, grade, histology and necrosis migration in a large European centre series over the last 27 years.

Methods The pathology reports of 2739 consecutive patients with RCC who underwent nephrectomy from 1984 to 2010 at the institution of the authors were systematically re-evaluated. Patients were pooled into five time groups according to the date of surgery: group 1: 1984–1989, group 2: 1990–1994, group 3: 1995–1999, group 4: 2000–2004 and group 5: 2005–2010, respectively. Changes in pT categories according to WHO 2010 classification, tumour grade, histological subtype and presence of tumour necrosis (TN) were evaluated.

Results Small pT1a tumours were found in 62/485 (12.8%) and 312/639 (48.8%) patients in groups 1 and 5, respectively (p<0.001). Advanced tumour stages (pT3a-4) were found in 306/485 (63.1%) and 171/639 (26.8%) patients in groups 1 and 5, respectively (p<0.001). The number of grade 3/4 tumours increased from 62/485 (12.7%) and 130/639 (20.3%) in groups 1 and 5, respectively, whereas the number of grade 1 tumours decreased over time (p<0.001). There has been a significant histological migration for the chromophobe subtype from 1.1% to 4.3% (p=0.002). The frequency of the presence TN decreased from 41.7% in group 1 to 32.7% in group 5 (p<0.001).

Conclusions In contrast to data from Australia but similar to data from US cohorts, a statistically significant stage migration towards small RCCs was observed in this European cohort. Significant changes in tumour grade, histological subtype and TN were also observed.

  • Caucasian population
  • renal cell carcinoma
  • stage migration
  • renal cancer
  • cancer research
  • genitourinary pathology

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  • Competing interests None declared.

  • Patient consent No intervention on patients has been performed, only retrospective data evaluation in an anonymous fashion.

  • Ethics approval Just analysis of data from database, retrospective design, without intervention on human subjects.

  • Provenance and peer review Not commissioned; externally peer reviewed.