More than ancillary records: clinical implications of renal pathology examination in tumor nephrectomy specimens - Sorbonne Université
Journal Articles Journal of Nephrology Year : 2021

More than ancillary records: clinical implications of renal pathology examination in tumor nephrectomy specimens

Abstract

Background: Nephrectomy is the management of choice for the treatment of renal tumors. Surgical pathologists primarily focus on tumor diagnosis and investigations relating to prognosis or therapy. Pathological changes in non-neoplastic tissue may, however, be relevant for further management and should be thoroughly assessed. Methods: Here, we examined the non-neoplastic renal parenchyma in 206 tumor nephrectomy specimens for the presence of glomerular, tubulo-interstitial, or vascular lesions, and correlated them with clinical parameters and outcome of renal function. Results: We analyzed 188 malignant and 18 benign or pseudo-tumorous lesions. The most common tumor type was clear cell renal cell carcinoma (CCRCC, n = 106) followed by papillary or urothelial carcinomas (n = 25). Renal pathology examination revealed the presence of kidney disease in 39 cases (18.9%). Glomerulonephritis was found in 15 cases (7.3%), and the most frequent was IgA nephropathy (n = 6; 2.9%). Vasculitis was found in two cases (0.9%). In 15 cases we found tubulo-interstitial nephritis, and in 9 severe diabetic or hypertensive nephropathy. Partial nephrectomy was not linked to better eGFR at follow-up. Age, vascular nephropathy, glomerular scarring and interstitial fibrosis were the leading independent negative factors influencing eGFR at time of surgery, whereas proteinuria was associated with reduced eGFR at 1 year. Conclusion: Our large study population indicates a high incidence of renal diseases potentially relevant for the postoperative management of patients with renal neoplasia. Consistent and systematic reporting of non-neoplastic renal pathology in tumor nephrectomy specimens should therefore be mandatory.
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Dates and versions

hal-03213294 , version 1 (30-04-2021)

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Johannes Philipp Kläger, Ahmad Al-Taleb, Mladen Pavlovic, Andrea Haitel, Eva Comperat, et al.. More than ancillary records: clinical implications of renal pathology examination in tumor nephrectomy specimens. Journal of Nephrology, 2021, 34, pp.1833-1844. ⟨10.1007/s40620-021-01030-0⟩. ⟨hal-03213294⟩
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