Fuhrman Grading is not Appropriate for Chromophobe Renal Cell Carcinoma

  title={Fuhrman Grading is not Appropriate for Chromophobe Renal Cell Carcinoma},
  author={Brett Delahunt and Dianne Sika-Paotonu and Peter B. Bethwaite and Margaret R. E. McCredie and Guido Martignoni and John N. Eble and T. William Jordan},
  journal={The American Journal of Surgical Pathology},
This study was undertaken to assess the prognostic effectiveness of Fuhrman nuclear grading and the individual components of this grading system, in a series of chromophobe renal cell carcinomas. Eighty-seven cases of chromophobe renal cell carcinoma were investigated. There were 47 males and 40 females, 28 to 78 years of age. The carcinomas ranged from 25 to 180 mm in size and on TNM staging there were 38 stage I, 25 stage II, 22 stage III, and 2 stage IV tumors. Whole tumor Fuhrman grading… 
Chromophobe Renal Cell Carcinoma: The Impact of Tumor Grade on Outcome
Although the chromophobe RCC grading system described by Paner and colleagues and nucleolar grade are associated with CS survival in chromophile RCC, they add no additional prognostic information once TNM stage and sarcomatoid differentiation are assessed.
Compare Fuhrman Nuclear and Chromophobe Tumor Grade on Chromophobe RCC
Chromophobe RCC was associated with a low rate of cancer-specific death and sarcomatoid differentiation and both FNG and CTG were associated with overall survival.
Chromophobe renal cell carcinoma: analysis of 53 cases
CRCC is an uncommon subtype of RCC, with a favorable prognosis, and Chinese patients are seemingly younger at diagnosis, while prediction of prognosis is still difficult.
Relating Prognosis in Chromophobe Renal Cell Carcinoma to the Chromophobe Tumor Grading System
ChRCC is associated with a very low rate of cancer specific events even at a tertiary referral center, and pathologic stage and CTG 3, but not CTG 1 or 2, were significantly associated with the development of these events.
Chromophobe Renal Cell Carcinoma: Histomorphologic Characteristics and Evaluation of Conventional Pathologic Prognostic Parameters in 145 Cases
The aggregate literature suggests that chromophobe renal cell carcinoma (RCC) is biologically a tumor of low malignant potential with reported 5-year and 10-year survival rates of 78% to 100% and 80% to 90%, respectively, while a distinct subset of patients progress, and the pT stage of tumor, tumor necrosis, and sarcomatoid change all predict aggressive phenotype of Chromophobe RCC.
Gleason and Fuhrman no longer make the grade
The most frequently used classifications for prostate adenocarcinoma and renal cell carcinoma fail to account for advances in the authors' understanding of the diagnostic features, classification and/or behaviour of these tumours.
A Novel Grading System for Clear Cell Renal Cell Carcinoma Incorporating Tumor Necrosis
It is concluded that grading for clear cell RCC should be based on nucleolar prominence and necrosis, that ISUP grading should be used for papillary RCC, and that chromophobe R CC should not be graded.


Nucleolar Grade But Not Fuhrman Grade is Applicable to Papillary Renal Cell Carcinoma
It is concluded that assessment of nucleolar prominence rather than Fuhrman grade is applicable for stratification of tumors within TNM stage or pT category for PRCC and that this should be based upon the high-power field showing the greatest degree of nuclear pleomorphism.
Prognostic significance of morphologic parameters in renal cell carcinoma
Nuclear grade and tumour stage were found as the most important prognostic indicators in renal cell carcinoma patients treated with radical nephrectomy between 1985 and 2001.
Comparison of standardized and nonstandardized nuclear grade of renal cell carcinoma to predict outcome among 2,042 patients.
Standardized nuclear grades were more predictive of death due to RCC than nonstandardized grades for all subtypes studied.
Chromophobe cell carcinoma of the kidney. A clinicopathologic study of 21 cases.
Findings further confirm the concept that chromophobe cell carcinomas is a special subtype of renal cell carcinoma in which the presence of microvesicles is a characteristic morphologic feature and loss of chromosomal DNA may also be a frequent, perhaps unique, feature of chromophobes.
Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience.
  • J. Patard, E. Leray, A. Pantuck
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2005
Prognostic Impact of Histologic Subtyping of Adult Renal Epithelial Neoplasms: An Experience of 405 Cases
It is shown that the histologic categorization of adult renal epithelial neoplasms performed by routine light microscopic hematoxylin and eosin-based examination in accordance with the contemporary classification scheme has prognostic utility.
Chromophobe cell renal carcinoma and its variants—a report on 32 cases
Immunocytochemical investigations on the intermediate filaments show a positive reaction for cytokeratins No. 18 and Nos. 7 and 19 for both variants, whereas vimentin was not found in any of these carcinomas, in contrast to the clear‐cell type.
Histopathologic prognostic indicators for renal cell carcinoma.
  • B. Delahunt
  • Medicine
    Seminars in diagnostic pathology
  • 1998
There is substantial agreement that tumors of high nuclear grade and those with sarcomatoid differentiation are associated with poor patient outcome, whereas the predictive nature of other grading categories is debated, and there is growing evidence to show that in four division grading systems, the upper two grading categories have similar survivals.
[Chromophobe renal cell carcinoma].