HISTOPATHOLOGICAL ANALYSIS OF PERITUMORAL PSEUDOCAPSULE AND SURGICAL MARGIN STATUS AFTER ENDOSCOPIC ROBOT-ASSISTED SIMPLE ENUCLEATION (ERASE) FOR RENAL CELL CARCINOMA.
Notice bibliographique
Résumé
Scopo del lavoro The Scopo del lavoro is to evaluate the peritumoral pseudocapsule (PS) and the surgical margin status at the tumor-parenchymal interface after ERASE for renal cell carcinoma (RCC). Materiali e metodi Data were prospectively collected from a cohort of 124 consecutive patients undergoing ERASE for malignant RCCs at our Institution. PS and healthy renal margin (HRM) thickness, PS infiltration and surgical margin status were analyzed by a dedicated uropathologist. Tumor histotype was classified according to the 2012 ISUP Vancouver Classification of Renal Neoplasia. Follow up was recorded at 6, 24 and 48 months. Risultati RCCs were classified as low, medium and high complexity (PADUA score 6-7, 8-9 and ≥10, respectively) in 69.4%, 23.4% and 7.2% of patients, respectively. Tumor histotypes was: clear cell (cc) RCC in 61.3% of patients, papillary (p) RCC in 14.5%, chromophobe (ch) RCC in 16.1%, multilocular cystic renal neoplasm of low malignant potential (MCCN-LMP) in 4.9% and clear cell papillary RCC (ccpRCC) in 3.2%. PS was absent in 1.6% of patients. Partial and complete PS infiltration were recorded in 39.0% and 17.1% of cases, while it was intact in 43.9%. Positive surgical margins were recorded in 2.4% of cases. Median thickness of PS and HRM were 263.3 (IQR 137.3-444.6) μm and 401.6 (IQR 137.9-921.2) μm. Peripheral and sinus fat invasion were recorded in 9.4% and 1.1 % of patients, respectively. Median PS thickness was significantly higher in ccpRCC and MCCN-LMP compared to the other histotypes (209 vs 389 μm; p=0.001). Among the latter subgroup, median PS thickness was significantly higher in ccRCC compared to pRCC and chRCC (220.2 vs 111.1 vs 59.5 ?m; p<0.001). Tumor diameter at histopathological analysis was significantly different between tumors with (PS+) and without (PS-) pseudocapsule infiltration (3 (IQR 2.4-4.0) vs 2.6 (IQR 1.9-3.5); p=0.05), as well as tumor histotype (p=0.01) , nucleolar grading (p=0.01) and pT status (p=0.002). On the contrary, there was no significant difference regarding PS and HRM thickness between the two groups. Discussione ccpRCC and MCCN-LMP showed a significantly thicker and less infiltrated PS compared to the other renal histotypes. PS infiltration was significantly associated with tumor diameter, grading and pT stage. Conclusioni In our cohort, there was no relationship between the degree of PS infiltration and both surgical margins status and local recurrence. However, further studies are needed to assess the long-term prognostic role of PS infiltration for RCC.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».