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Reclassification of the Fuhrman grading system in renal cell carcinoma-does it make a difference?

Qayyum T, McArdle P, Orange C, Seywright M, Horgan P, Oades G, Aitchison M, Edwards J - Springerplus (2013)

Bottom Line: The original Fuhrman grading system was investigated as well as various simplified models utilising the original Fuhrman grade.The median follow up was 69 months.Furthermore this simplified model demonstrated a stronger relationship to recurrence than the conventional 4 tiered Fuhrman grading system.

View Article: PubMed Central - PubMed

Affiliation: Unit of Experimental Therapeutics, Institute of Cancer, College of MVLS, University of Glasgow, Western Infirmary, Glasgow, G11 6NT Scotland, UK.

ABSTRACT

Purpose: The aim of this study was to determine whether reclassifying the Fuhrman grading system provides further prognostic information.

Materials and methods: We studied the pathological features and cancer specific survival of 237 patients with clear cell cancer undergoing surgery between 1997-2007 in a single centre. The original Fuhrman grading system was investigated as well as various simplified models utilising the original Fuhrman grade.

Results: The median follow up was 69 months. On univariate analysis, the conventional Fuhrman grading system as well various simplified models were predicative of cancer specific survival. On multivariate analysis, only the three tiered modified model in which grades 1 and 2 were combined whilst grades 3 and 4 were kept separate was an independent predictor of cancer specific survival (p=0.001, HR 2.17, 95% CI 1.37-3.43). Furthermore this simplified model demonstrated a stronger relationship to recurrence than the conventional 4 tiered Fuhrman grading system.

Conclusions: A modified, three-tiered Fuhrman grading system has been demonstrated to be an independent predictor of cancer specific survival.

No MeSH data available.


Related in: MedlinePlus

Kaplan Meier graphs demonstrating the conventional 4 tiered Fuhrman grading system (p=0.005) and a simplified model where grades 1 and 2 are combined and grades 3 and 4 are kept separate (p=0.002) against disease specific survival.
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Fig1: Kaplan Meier graphs demonstrating the conventional 4 tiered Fuhrman grading system (p=0.005) and a simplified model where grades 1 and 2 are combined and grades 3 and 4 are kept separate (p=0.002) against disease specific survival.

Mentions: Univariate analysis of potential predictors of cancer specific survival showed that the majority of the grading models were statistically significant predictors of cancer specific survival (Table 3, Figure 1). On multivariate analysis of those that were significant on univariate, only model 5 which is a modified three tired model combining grades 1 and 2 whilst grades 3 and 4 are kept as separate was found to be an independent prognostic factor in its association with cancer specific survival (p=0.001, HR 2.17, 95% CI 1.37-3.43, Table 3).Table 3


Reclassification of the Fuhrman grading system in renal cell carcinoma-does it make a difference?

Qayyum T, McArdle P, Orange C, Seywright M, Horgan P, Oades G, Aitchison M, Edwards J - Springerplus (2013)

Kaplan Meier graphs demonstrating the conventional 4 tiered Fuhrman grading system (p=0.005) and a simplified model where grades 1 and 2 are combined and grades 3 and 4 are kept separate (p=0.002) against disease specific survival.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3755806&req=5

Fig1: Kaplan Meier graphs demonstrating the conventional 4 tiered Fuhrman grading system (p=0.005) and a simplified model where grades 1 and 2 are combined and grades 3 and 4 are kept separate (p=0.002) against disease specific survival.
Mentions: Univariate analysis of potential predictors of cancer specific survival showed that the majority of the grading models were statistically significant predictors of cancer specific survival (Table 3, Figure 1). On multivariate analysis of those that were significant on univariate, only model 5 which is a modified three tired model combining grades 1 and 2 whilst grades 3 and 4 are kept as separate was found to be an independent prognostic factor in its association with cancer specific survival (p=0.001, HR 2.17, 95% CI 1.37-3.43, Table 3).Table 3

Bottom Line: The original Fuhrman grading system was investigated as well as various simplified models utilising the original Fuhrman grade.The median follow up was 69 months.Furthermore this simplified model demonstrated a stronger relationship to recurrence than the conventional 4 tiered Fuhrman grading system.

View Article: PubMed Central - PubMed

Affiliation: Unit of Experimental Therapeutics, Institute of Cancer, College of MVLS, University of Glasgow, Western Infirmary, Glasgow, G11 6NT Scotland, UK.

ABSTRACT

Purpose: The aim of this study was to determine whether reclassifying the Fuhrman grading system provides further prognostic information.

Materials and methods: We studied the pathological features and cancer specific survival of 237 patients with clear cell cancer undergoing surgery between 1997-2007 in a single centre. The original Fuhrman grading system was investigated as well as various simplified models utilising the original Fuhrman grade.

Results: The median follow up was 69 months. On univariate analysis, the conventional Fuhrman grading system as well various simplified models were predicative of cancer specific survival. On multivariate analysis, only the three tiered modified model in which grades 1 and 2 were combined whilst grades 3 and 4 were kept separate was an independent predictor of cancer specific survival (p=0.001, HR 2.17, 95% CI 1.37-3.43). Furthermore this simplified model demonstrated a stronger relationship to recurrence than the conventional 4 tiered Fuhrman grading system.

Conclusions: A modified, three-tiered Fuhrman grading system has been demonstrated to be an independent predictor of cancer specific survival.

No MeSH data available.


Related in: MedlinePlus