DOES PATHOLOGICAL T3A UPSTAGING OF CLINICAL T1 STAGE HAS ANY DIFFERENCE ON LONG-TERM SURVIVAL WHEN COMPARED TO PATHOLOGICAL AND CLINICAL T1 STAGE RENAL CELL CARCINOMA

Background: A high number of clinical T1 (cT1) stage renal cell carcinoma (RCC) is upstaged to pathological T3a (pT3a) stage on histopathological findings. Several study results show that there is no survival difference among those cT1 stage who are upstaged on histopathological findings to those who remain pT1 stage RCC.Objectives: The objectives of this study were to assess any survival difference for cT1 stage renal cell carcinoma (RCC) which is upstaged to pT3a stage as compared to those which remain pT1 stage RCC on histopathological findings.Materials and Methods: It was a retrospective cohort study looking at patient aged ≥18 years with cT1 RCC who underwent nephrectomy between January 2006 and December 2016. Patients were divided into two groups based on histopathological findings (pT1 vs. pT3a). Survival was analysed for the  two groups using Kaplan–Meier method, and the difference in survival was calculated using log-rank model.Results: The study included 187 patients. The mean age at presentation was 52.56 years, with 58.3% of the patients being male while 41.7% were female. The most common presentation was incidental diagnosis (50.3%). Overall5-year survival for cT1a and pT1a RCC was 68% while that for cT1a and pT3a RCC was 100%. There was no significant survival difference among the two groups (P = 0.316). The overall 5-year survival for cT1b and pT1b RCC was 81% while that for cT1b and pT3a was 65%. There was no significant survival difference among the two groups (P = 0.136).Conclusion: We found no survival difference in cT1 RCC who were upstaged to pT3a on histopathology as compared to cT1 RCC-staged pT1 on histopathology.Key words: Clinical T1 stage, pathological T3a stage, radical nephrectomy, renal cell carcinoma, survival