Abstract

Objective: To investigate the impact of renal capsular infiltration on disease specific survival in pathologically localized renal cell carcinoma. 

Materials and methods: The medical records of 89 patients with pT1-3aN0M0 renal cell carcinoma who underwent open radical nephrectomy in our institution between 2000-2009 were evaluated retrospectively. The prognostic value of renal capsular involvement was investigated with univariate and multivariate survival analyses in patients with pT1-2N0M0 disease. 

Results: Capsular involvement was present in 26 of 79 (32.9%) pT1-2N0M0 patients. The 3-year disease specific survival rates for patients with and without capsular infiltration were 75.4% and 97.7%, respectively (p<0.001). Similarly, capsular involvement worsened disease specific survival in pT1 patients (80% vs. 100%, p=0.002), although it had had no impact on survival of pT2 patients (72.9% vs 93.3%, p=0.168). Multivariate survival analysis revealed that capsular involvement was an idependent prognostic factor (HR=13.213, p=0.021). Three-year disease specific survival for capsule positive pT1-2 patients were similar with that of pT3 patients (75.4% vs. 72%, p=0.544).

Conclusion: Capsular infiltration is an independent prognostic factor in localized renal cell carcinoma. The presence of capsular infiltration significantly reduces disease specific survival rates in pT1 renal cell carcinoma. Capsular infiltration in pT1-2 renal cell carcinoma decreases prognosis to levels similar to those of pT3a patients.