A Comparison of prognostic value of Three-tiered grading method with Fuhrman methods for renal cell carcinoma

Introduction: recent studies have shown that due to the specific cellular, molecular structure and histochemistry of chromophobe renal cell carcinoma (RCC), tumor grading system does not have enough accuracy, and thereby is not suitable for grading of this carcinoma. In this study we tried to evaluate and compare prognostic value of Fuhrman and Three-tiered grading methods for chromophobe RCC was investigated.Material and Method: In a cross-sectional study, pathology blocks of 57 patients with histologically RCC were evaluated and graded according to Fuhrman and Three-tiered methods. Also, other information such as pathology, tumor size and tumor stage with regard to vascular invasion, and involvement of renal sinus, adrenal, and renal hilum lymph nodes were obtained from the patients’ pathology reports. All data were analyzed by using SPSS software.Results: the frequencies of tumor grades were significantly different based on Fuhrman and the Three-tiered methods (P < 0.05). There was a significant positive correlation between age of the patients and tumor grade based on Fuhrman method, and also between age, tumor size, tumor stage, tumor vascular invasion and tumor grade based on the Three-tiered method. However, according to Fuhrman method, no correlation was found between tumor grade and tumor size, tumor stage, tumor vascular invasion and three-year survival of the patients. Also, there was no correlation between tumor grade and survival of these patients according to the Three-tiered method.Conclusion: It seems that the Three-tiered method compared to the Fuhrman method, is a more accurate grading system and has a higher prognostic value for RCC. However, further confirmatory studies in future are suggested.

A Comparison of prognostic value of Three-tiered grading method with Fuhrman methods for renal cell carcinoma Keywords:

Chromophobe renal cell carcinoma , Fuhrman , Prognosis , Tumor grade , Three-tiered