The International Society of Urological Pathology (ISUP) grading system for renal cell carcinoma and other prognostic parameters

Brett Delahunt, John C. Cheville, Guido Martignoni, Peter A. Humphrey, Cristina Magi-Galluzzi, Jesse McKenney, Lars Egevad, Ferran Algaba, Holger Moch, David Grignon, Rodolfo Montironi, John R. Srigley, Anila Abraham, Adebowale Adeniran, Khalid Ahmed, Hikmat Al Ahmadie, Robert Allan, Mahul Amin, Pedram Argani, Ulrika Axcrona & 111 others Marc Barry, Dilek Baydar, Louis Bégin, Dan Berney, Peter Bethwaite, Athanase Billis, Ruth Birbe, Stephen Bonsib, David Bostwick, Fadi Brimo, Helen Cathro, Ying Bei Chen, Liang Cheng, Yong Mee Cho, Ai Ying Chuang, Cynthia Cohen, Henry Crist, Warick Delprado, Fang Ming Deng, Jonathan Epstein, Andrew Evans, Oluwole Fadare, Daniel Fajardo, Sara Falzarano, Samson Fine, Stewart Fleming, Eddie Fridman, Bungo Furusato, Masoud Ganji, Masoumeh Ghayouri, Giovanna Giannico, Neriman Gokden, David Griffiths, Nilesh Gupta, Omar Hameed, Ondrej Hes, Michelle Hirsch, Jiaoti Huang, Wei Huang, Christina Hulsbergen Van De Kaa, Sundus Hussein, Kenneth Iczkowski, Rafael Jimenez, Edward Jones, Laura Irene Jufe, James Kench, Masatoshi Kida, Glen Kristiansen, Lakshmi Priya Kunju, Zhaoli Lane, Mathieu Latour, Claudio Lewin, Kathrine Lie, Josep Lloreta, Barbara Loftus, Antonio Lopez-Beltran, Fiona Maclean, Teresa McHale, Maria Merino, Rose Miller, Hiroshi Miyamoto, Hedwig Murphy, John Nacey, Tipu Nazeer, Gabriella Nesi, George Netto, Peter Nichols, Marie O'Donnell, Semra Olgac, Roberto Orozco, Adeboye Osunkoya, Aysim Ozagari, Chin Chen Pan, Anil Parwani, Joanna Perry-Keene, Constantina Petraki, Maria Picken, Maria Pyda-Karwicka, Victor Reuter, Katayoon Rezaei, Nathalie Rioux-Leclercq, Brian Robinson, Stephen Rohan, Ruben Ronchetti, Laurie Russell, Marina Scarpelli, Ahmed Shabaik, Rajal Shah, Jonathan Shanks, Steven Shen, Maria Shevchuk, Mathilde Sibony, Bhuvana Srinivasan, Martin Susani, Sueli Suzigan, Joan Sweet, Hiroyuki Takahashi, Puay Hoon Tan, Satish Tickoo, Isabel Trias, Larry True, Toyonori Tsuzuki, Funda Vakar-Lopez, Theo Van Der Kwast, Cheng Wang, Anne Warren, Jorge Yao, Asli Yilmaz, Jin Zhao, Ming Zhou, Debra Zynger

Research output: Contribution to journalArticle

277 Citations (Scopus)

Abstract

The International Society of Urological Pathology 2012 Consensus Conference made recommendations regarding classification, prognostic factors, staging, and immunohistochemical and molecular assessment of adult renal tumors. Issues relating to prognostic factors were coordinated by a workgroup who identified tumor morphotype, sarcomatoid/rhabdoid differentiation, tumor necrosis, grading, and microvascular invasion as potential prognostic parameters. There was consensus that the main morphotypes of renal cell carcinoma (RCC) were of prognostic significance, that subtyping of papillary RCC (types 1 and 2) provided additional prognostic information, and that clear cell tubulopapillary RCC was associated with a more favorable outcome. For tumors showing sarcomatoid or rhabdoid differentiation, there was consensus that a minimum proportion of tumor was not required for diagnostic purposes. It was also agreed upon that the underlying subtype of carcinoma should be reported. For sarcomatoid carcinoma, it was further agreed upon that if the underlying carcinoma subtype was absent the tumor should be classified as a grade 4 unclassified carcinoma with a sarcomatoid component. Tumor necrosis was considered to have prognostic significance, with assessment based on macroscopic and microscopic examination of the tumor. It was recommended that for clear cell RCC the amount of necrosis should be quantified. There was consensus that nucleolar prominence defined grades 1 to 3 of clear cell and papillary RCCs, whereas extreme nuclear pleomorphism or sarcomatoid and/or rhabdoid differentiation defined grade 4 tumors. It was agreed upon that chromophobe RCC should not be graded. There was consensus that microvascular invasion should not be included as a staging criterion for RCC.

Original languageEnglish
Pages (from-to)1490-1504
Number of pages15
JournalAmerican Journal of Surgical Pathology
Volume37
Issue number10
DOIs
StatePublished - 2013

Fingerprint

Renal Cell Carcinoma
Pathology
Neoplasms
Carcinoma
Necrosis
Rhabdoid Tumor
Neoplasm Grading
Kidney

Keywords

  • Grade
  • International Society of Urological Pathology
  • Kidney
  • Microvascular invasion
  • Necrosis
  • Pathology
  • Renal cell carcinoma
  • Rhabdoid differentiation
  • Sarcomatoid differentiation
  • Tumor morphotype

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine
  • Surgery

Cite this

Delahunt, B., Cheville, J. C., Martignoni, G., Humphrey, P. A., Magi-Galluzzi, C., McKenney, J., ... Zynger, D. (2013). The International Society of Urological Pathology (ISUP) grading system for renal cell carcinoma and other prognostic parameters. American Journal of Surgical Pathology, 37(10), 1490-1504. https://doi.org/10.1097/PAS.0b013e318299f0fb

The International Society of Urological Pathology (ISUP) grading system for renal cell carcinoma and other prognostic parameters. / Delahunt, Brett; Cheville, John C.; Martignoni, Guido; Humphrey, Peter A.; Magi-Galluzzi, Cristina; McKenney, Jesse; Egevad, Lars; Algaba, Ferran; Moch, Holger; Grignon, David; Montironi, Rodolfo; Srigley, John R.; Abraham, Anila; Adeniran, Adebowale; Ahmed, Khalid; Al Ahmadie, Hikmat; Allan, Robert; Amin, Mahul; Argani, Pedram; Axcrona, Ulrika; Barry, Marc; Baydar, Dilek; Bégin, Louis; Berney, Dan; Bethwaite, Peter; Billis, Athanase; Birbe, Ruth; Bonsib, Stephen; Bostwick, David; Brimo, Fadi; Cathro, Helen; Chen, Ying Bei; Cheng, Liang; Cho, Yong Mee; Chuang, Ai Ying; Cohen, Cynthia; Crist, Henry; Delprado, Warick; Deng, Fang Ming; Epstein, Jonathan; Evans, Andrew; Fadare, Oluwole; Fajardo, Daniel; Falzarano, Sara; Fine, Samson; Fleming, Stewart; Fridman, Eddie; Furusato, Bungo; Ganji, Masoud; Ghayouri, Masoumeh; Giannico, Giovanna; Gokden, Neriman; Griffiths, David; Gupta, Nilesh; Hameed, Omar; Hes, Ondrej; Hirsch, Michelle; Huang, Jiaoti; Huang, Wei; Van De Kaa, Christina Hulsbergen; Hussein, Sundus; Iczkowski, Kenneth; Jimenez, Rafael; Jones, Edward; Jufe, Laura Irene; Kench, James; Kida, Masatoshi; Kristiansen, Glen; Kunju, Lakshmi Priya; Lane, Zhaoli; Latour, Mathieu; Lewin, Claudio; Lie, Kathrine; Lloreta, Josep; Loftus, Barbara; Lopez-Beltran, Antonio; Maclean, Fiona; McHale, Teresa; Merino, Maria; Miller, Rose; Miyamoto, Hiroshi; Murphy, Hedwig; Nacey, John; Nazeer, Tipu; Nesi, Gabriella; Netto, George; Nichols, Peter; O'Donnell, Marie; Olgac, Semra; Orozco, Roberto; Osunkoya, Adeboye; Ozagari, Aysim; Pan, Chin Chen; Parwani, Anil; Perry-Keene, Joanna; Petraki, Constantina; Picken, Maria; Pyda-Karwicka, Maria; Reuter, Victor; Rezaei, Katayoon; Rioux-Leclercq, Nathalie; Robinson, Brian; Rohan, Stephen; Ronchetti, Ruben; Russell, Laurie; Scarpelli, Marina; Shabaik, Ahmed; Shah, Rajal; Shanks, Jonathan; Shen, Steven; Shevchuk, Maria; Sibony, Mathilde; Srinivasan, Bhuvana; Susani, Martin; Suzigan, Sueli; Sweet, Joan; Takahashi, Hiroyuki; Tan, Puay Hoon; Tickoo, Satish; Trias, Isabel; True, Larry; Tsuzuki, Toyonori; Vakar-Lopez, Funda; Van Der Kwast, Theo; Wang, Cheng; Warren, Anne; Yao, Jorge; Yilmaz, Asli; Zhao, Jin; Zhou, Ming; Zynger, Debra.

In: American Journal of Surgical Pathology, Vol. 37, No. 10, 2013, p. 1490-1504.

Research output: Contribution to journalArticle

Delahunt, B, Cheville, JC, Martignoni, G, Humphrey, PA, Magi-Galluzzi, C, McKenney, J, Egevad, L, Algaba, F, Moch, H, Grignon, D, Montironi, R, Srigley, JR, Abraham, A, Adeniran, A, Ahmed, K, Al Ahmadie, H, Allan, R, Amin, M, Argani, P, Axcrona, U, Barry, M, Baydar, D, Bégin, L, Berney, D, Bethwaite, P, Billis, A, Birbe, R, Bonsib, S, Bostwick, D, Brimo, F, Cathro, H, Chen, YB, Cheng, L, Cho, YM, Chuang, AY, Cohen, C, Crist, H, Delprado, W, Deng, FM, Epstein, J, Evans, A, Fadare, O, Fajardo, D, Falzarano, S, Fine, S, Fleming, S, Fridman, E, Furusato, B, Ganji, M, Ghayouri, M, Giannico, G, Gokden, N, Griffiths, D, Gupta, N, Hameed, O, Hes, O, Hirsch, M, Huang, J, Huang, W, Van De Kaa, CH, Hussein, S, Iczkowski, K, Jimenez, R, Jones, E, Jufe, LI, Kench, J, Kida, M, Kristiansen, G, Kunju, LP, Lane, Z, Latour, M, Lewin, C, Lie, K, Lloreta, J, Loftus, B, Lopez-Beltran, A, Maclean, F, McHale, T, Merino, M, Miller, R, Miyamoto, H, Murphy, H, Nacey, J, Nazeer, T, Nesi, G, Netto, G, Nichols, P, O'Donnell, M, Olgac, S, Orozco, R, Osunkoya, A, Ozagari, A, Pan, CC, Parwani, A, Perry-Keene, J, Petraki, C, Picken, M, Pyda-Karwicka, M, Reuter, V, Rezaei, K, Rioux-Leclercq, N, Robinson, B, Rohan, S, Ronchetti, R, Russell, L, Scarpelli, M, Shabaik, A, Shah, R, Shanks, J, Shen, S, Shevchuk, M, Sibony, M, Srinivasan, B, Susani, M, Suzigan, S, Sweet, J, Takahashi, H, Tan, PH, Tickoo, S, Trias, I, True, L, Tsuzuki, T, Vakar-Lopez, F, Van Der Kwast, T, Wang, C, Warren, A, Yao, J, Yilmaz, A, Zhao, J, Zhou, M & Zynger, D 2013, 'The International Society of Urological Pathology (ISUP) grading system for renal cell carcinoma and other prognostic parameters', American Journal of Surgical Pathology, vol. 37, no. 10, pp. 1490-1504. https://doi.org/10.1097/PAS.0b013e318299f0fb
Delahunt, Brett ; Cheville, John C. ; Martignoni, Guido ; Humphrey, Peter A. ; Magi-Galluzzi, Cristina ; McKenney, Jesse ; Egevad, Lars ; Algaba, Ferran ; Moch, Holger ; Grignon, David ; Montironi, Rodolfo ; Srigley, John R. ; Abraham, Anila ; Adeniran, Adebowale ; Ahmed, Khalid ; Al Ahmadie, Hikmat ; Allan, Robert ; Amin, Mahul ; Argani, Pedram ; Axcrona, Ulrika ; Barry, Marc ; Baydar, Dilek ; Bégin, Louis ; Berney, Dan ; Bethwaite, Peter ; Billis, Athanase ; Birbe, Ruth ; Bonsib, Stephen ; Bostwick, David ; Brimo, Fadi ; Cathro, Helen ; Chen, Ying Bei ; Cheng, Liang ; Cho, Yong Mee ; Chuang, Ai Ying ; Cohen, Cynthia ; Crist, Henry ; Delprado, Warick ; Deng, Fang Ming ; Epstein, Jonathan ; Evans, Andrew ; Fadare, Oluwole ; Fajardo, Daniel ; Falzarano, Sara ; Fine, Samson ; Fleming, Stewart ; Fridman, Eddie ; Furusato, Bungo ; Ganji, Masoud ; Ghayouri, Masoumeh ; Giannico, Giovanna ; Gokden, Neriman ; Griffiths, David ; Gupta, Nilesh ; Hameed, Omar ; Hes, Ondrej ; Hirsch, Michelle ; Huang, Jiaoti ; Huang, Wei ; Van De Kaa, Christina Hulsbergen ; Hussein, Sundus ; Iczkowski, Kenneth ; Jimenez, Rafael ; Jones, Edward ; Jufe, Laura Irene ; Kench, James ; Kida, Masatoshi ; Kristiansen, Glen ; Kunju, Lakshmi Priya ; Lane, Zhaoli ; Latour, Mathieu ; Lewin, Claudio ; Lie, Kathrine ; Lloreta, Josep ; Loftus, Barbara ; Lopez-Beltran, Antonio ; Maclean, Fiona ; McHale, Teresa ; Merino, Maria ; Miller, Rose ; Miyamoto, Hiroshi ; Murphy, Hedwig ; Nacey, John ; Nazeer, Tipu ; Nesi, Gabriella ; Netto, George ; Nichols, Peter ; O'Donnell, Marie ; Olgac, Semra ; Orozco, Roberto ; Osunkoya, Adeboye ; Ozagari, Aysim ; Pan, Chin Chen ; Parwani, Anil ; Perry-Keene, Joanna ; Petraki, Constantina ; Picken, Maria ; Pyda-Karwicka, Maria ; Reuter, Victor ; Rezaei, Katayoon ; Rioux-Leclercq, Nathalie ; Robinson, Brian ; Rohan, Stephen ; Ronchetti, Ruben ; Russell, Laurie ; Scarpelli, Marina ; Shabaik, Ahmed ; Shah, Rajal ; Shanks, Jonathan ; Shen, Steven ; Shevchuk, Maria ; Sibony, Mathilde ; Srinivasan, Bhuvana ; Susani, Martin ; Suzigan, Sueli ; Sweet, Joan ; Takahashi, Hiroyuki ; Tan, Puay Hoon ; Tickoo, Satish ; Trias, Isabel ; True, Larry ; Tsuzuki, Toyonori ; Vakar-Lopez, Funda ; Van Der Kwast, Theo ; Wang, Cheng ; Warren, Anne ; Yao, Jorge ; Yilmaz, Asli ; Zhao, Jin ; Zhou, Ming ; Zynger, Debra. / The International Society of Urological Pathology (ISUP) grading system for renal cell carcinoma and other prognostic parameters. In: American Journal of Surgical Pathology. 2013 ; Vol. 37, No. 10. pp. 1490-1504.
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title = "The International Society of Urological Pathology (ISUP) grading system for renal cell carcinoma and other prognostic parameters",
abstract = "The International Society of Urological Pathology 2012 Consensus Conference made recommendations regarding classification, prognostic factors, staging, and immunohistochemical and molecular assessment of adult renal tumors. Issues relating to prognostic factors were coordinated by a workgroup who identified tumor morphotype, sarcomatoid/rhabdoid differentiation, tumor necrosis, grading, and microvascular invasion as potential prognostic parameters. There was consensus that the main morphotypes of renal cell carcinoma (RCC) were of prognostic significance, that subtyping of papillary RCC (types 1 and 2) provided additional prognostic information, and that clear cell tubulopapillary RCC was associated with a more favorable outcome. For tumors showing sarcomatoid or rhabdoid differentiation, there was consensus that a minimum proportion of tumor was not required for diagnostic purposes. It was also agreed upon that the underlying subtype of carcinoma should be reported. For sarcomatoid carcinoma, it was further agreed upon that if the underlying carcinoma subtype was absent the tumor should be classified as a grade 4 unclassified carcinoma with a sarcomatoid component. Tumor necrosis was considered to have prognostic significance, with assessment based on macroscopic and microscopic examination of the tumor. It was recommended that for clear cell RCC the amount of necrosis should be quantified. There was consensus that nucleolar prominence defined grades 1 to 3 of clear cell and papillary RCCs, whereas extreme nuclear pleomorphism or sarcomatoid and/or rhabdoid differentiation defined grade 4 tumors. It was agreed upon that chromophobe RCC should not be graded. There was consensus that microvascular invasion should not be included as a staging criterion for RCC.",
keywords = "Grade, International Society of Urological Pathology, Kidney, Microvascular invasion, Necrosis, Pathology, Renal cell carcinoma, Rhabdoid differentiation, Sarcomatoid differentiation, Tumor morphotype",
author = "Brett Delahunt and Cheville, {John C.} and Guido Martignoni and Humphrey, {Peter A.} and Cristina Magi-Galluzzi and Jesse McKenney and Lars Egevad and Ferran Algaba and Holger Moch and David Grignon and Rodolfo Montironi and Srigley, {John R.} and Anila Abraham and Adebowale Adeniran and Khalid Ahmed and {Al Ahmadie}, Hikmat and Robert Allan and Mahul Amin and Pedram Argani and Ulrika Axcrona and Marc Barry and Dilek Baydar and Louis B{\'e}gin and Dan Berney and Peter Bethwaite and Athanase Billis and Ruth Birbe and Stephen Bonsib and David Bostwick and Fadi Brimo and Helen Cathro and Chen, {Ying Bei} and Liang Cheng and Cho, {Yong Mee} and Chuang, {Ai Ying} and Cynthia Cohen and Henry Crist and Warick Delprado and Deng, {Fang Ming} and Jonathan Epstein and Andrew Evans and Oluwole Fadare and Daniel Fajardo and Sara Falzarano and Samson Fine and Stewart Fleming and Eddie Fridman and Bungo Furusato and Masoud Ganji and Masoumeh Ghayouri and Giovanna Giannico and Neriman Gokden and David Griffiths and Nilesh Gupta and Omar Hameed and Ondrej Hes and Michelle Hirsch and Jiaoti Huang and Wei Huang and {Van De Kaa}, {Christina Hulsbergen} and Sundus Hussein and Kenneth Iczkowski and Rafael Jimenez and Edward Jones and Jufe, {Laura Irene} and James Kench and Masatoshi Kida and Glen Kristiansen and Kunju, {Lakshmi Priya} and Zhaoli Lane and Mathieu Latour and Claudio Lewin and Kathrine Lie and Josep Lloreta and Barbara Loftus and Antonio Lopez-Beltran and Fiona Maclean and Teresa McHale and Maria Merino and Rose Miller and Hiroshi Miyamoto and Hedwig Murphy and John Nacey and Tipu Nazeer and Gabriella Nesi and George Netto and Peter Nichols and Marie O'Donnell and Semra Olgac and Roberto Orozco and Adeboye Osunkoya and Aysim Ozagari and Pan, {Chin Chen} and Anil Parwani and Joanna Perry-Keene and Constantina Petraki and Maria Picken and Maria Pyda-Karwicka and Victor Reuter and Katayoon Rezaei and Nathalie Rioux-Leclercq and Brian Robinson and Stephen Rohan and Ruben Ronchetti and Laurie Russell and Marina Scarpelli and Ahmed Shabaik and Rajal Shah and Jonathan Shanks and Steven Shen and Maria Shevchuk and Mathilde Sibony and Bhuvana Srinivasan and Martin Susani and Sueli Suzigan and Joan Sweet and Hiroyuki Takahashi and Tan, {Puay Hoon} and Satish Tickoo and Isabel Trias and Larry True and Toyonori Tsuzuki and Funda Vakar-Lopez and {Van Der Kwast}, Theo and Cheng Wang and Anne Warren and Jorge Yao and Asli Yilmaz and Jin Zhao and Ming Zhou and Debra Zynger",
year = "2013",
doi = "10.1097/PAS.0b013e318299f0fb",
language = "English",
volume = "37",
pages = "1490--1504",
journal = "American Journal of Surgical Pathology",
issn = "0147-5185",
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TY - JOUR

T1 - The International Society of Urological Pathology (ISUP) grading system for renal cell carcinoma and other prognostic parameters

AU - Delahunt, Brett

AU - Cheville, John C.

AU - Martignoni, Guido

AU - Humphrey, Peter A.

AU - Magi-Galluzzi, Cristina

AU - McKenney, Jesse

AU - Egevad, Lars

AU - Algaba, Ferran

AU - Moch, Holger

AU - Grignon, David

AU - Montironi, Rodolfo

AU - Srigley, John R.

AU - Abraham, Anila

AU - Adeniran, Adebowale

AU - Ahmed, Khalid

AU - Al Ahmadie, Hikmat

AU - Allan, Robert

AU - Amin, Mahul

AU - Argani, Pedram

AU - Axcrona, Ulrika

AU - Barry, Marc

AU - Baydar, Dilek

AU - Bégin, Louis

AU - Berney, Dan

AU - Bethwaite, Peter

AU - Billis, Athanase

AU - Birbe, Ruth

AU - Bonsib, Stephen

AU - Bostwick, David

AU - Brimo, Fadi

AU - Cathro, Helen

AU - Chen, Ying Bei

AU - Cheng, Liang

AU - Cho, Yong Mee

AU - Chuang, Ai Ying

AU - Cohen, Cynthia

AU - Crist, Henry

AU - Delprado, Warick

AU - Deng, Fang Ming

AU - Epstein, Jonathan

AU - Evans, Andrew

AU - Fadare, Oluwole

AU - Fajardo, Daniel

AU - Falzarano, Sara

AU - Fine, Samson

AU - Fleming, Stewart

AU - Fridman, Eddie

AU - Furusato, Bungo

AU - Ganji, Masoud

AU - Ghayouri, Masoumeh

AU - Giannico, Giovanna

AU - Gokden, Neriman

AU - Griffiths, David

AU - Gupta, Nilesh

AU - Hameed, Omar

AU - Hes, Ondrej

AU - Hirsch, Michelle

AU - Huang, Jiaoti

AU - Huang, Wei

AU - Van De Kaa, Christina Hulsbergen

AU - Hussein, Sundus

AU - Iczkowski, Kenneth

AU - Jimenez, Rafael

AU - Jones, Edward

AU - Jufe, Laura Irene

AU - Kench, James

AU - Kida, Masatoshi

AU - Kristiansen, Glen

AU - Kunju, Lakshmi Priya

AU - Lane, Zhaoli

AU - Latour, Mathieu

AU - Lewin, Claudio

AU - Lie, Kathrine

AU - Lloreta, Josep

AU - Loftus, Barbara

AU - Lopez-Beltran, Antonio

AU - Maclean, Fiona

AU - McHale, Teresa

AU - Merino, Maria

AU - Miller, Rose

AU - Miyamoto, Hiroshi

AU - Murphy, Hedwig

AU - Nacey, John

AU - Nazeer, Tipu

AU - Nesi, Gabriella

AU - Netto, George

AU - Nichols, Peter

AU - O'Donnell, Marie

AU - Olgac, Semra

AU - Orozco, Roberto

AU - Osunkoya, Adeboye

AU - Ozagari, Aysim

AU - Pan, Chin Chen

AU - Parwani, Anil

AU - Perry-Keene, Joanna

AU - Petraki, Constantina

AU - Picken, Maria

AU - Pyda-Karwicka, Maria

AU - Reuter, Victor

AU - Rezaei, Katayoon

AU - Rioux-Leclercq, Nathalie

AU - Robinson, Brian

AU - Rohan, Stephen

AU - Ronchetti, Ruben

AU - Russell, Laurie

AU - Scarpelli, Marina

AU - Shabaik, Ahmed

AU - Shah, Rajal

AU - Shanks, Jonathan

AU - Shen, Steven

AU - Shevchuk, Maria

AU - Sibony, Mathilde

AU - Srinivasan, Bhuvana

AU - Susani, Martin

AU - Suzigan, Sueli

AU - Sweet, Joan

AU - Takahashi, Hiroyuki

AU - Tan, Puay Hoon

AU - Tickoo, Satish

AU - Trias, Isabel

AU - True, Larry

AU - Tsuzuki, Toyonori

AU - Vakar-Lopez, Funda

AU - Van Der Kwast, Theo

AU - Wang, Cheng

AU - Warren, Anne

AU - Yao, Jorge

AU - Yilmaz, Asli

AU - Zhao, Jin

AU - Zhou, Ming

AU - Zynger, Debra

PY - 2013

Y1 - 2013

N2 - The International Society of Urological Pathology 2012 Consensus Conference made recommendations regarding classification, prognostic factors, staging, and immunohistochemical and molecular assessment of adult renal tumors. Issues relating to prognostic factors were coordinated by a workgroup who identified tumor morphotype, sarcomatoid/rhabdoid differentiation, tumor necrosis, grading, and microvascular invasion as potential prognostic parameters. There was consensus that the main morphotypes of renal cell carcinoma (RCC) were of prognostic significance, that subtyping of papillary RCC (types 1 and 2) provided additional prognostic information, and that clear cell tubulopapillary RCC was associated with a more favorable outcome. For tumors showing sarcomatoid or rhabdoid differentiation, there was consensus that a minimum proportion of tumor was not required for diagnostic purposes. It was also agreed upon that the underlying subtype of carcinoma should be reported. For sarcomatoid carcinoma, it was further agreed upon that if the underlying carcinoma subtype was absent the tumor should be classified as a grade 4 unclassified carcinoma with a sarcomatoid component. Tumor necrosis was considered to have prognostic significance, with assessment based on macroscopic and microscopic examination of the tumor. It was recommended that for clear cell RCC the amount of necrosis should be quantified. There was consensus that nucleolar prominence defined grades 1 to 3 of clear cell and papillary RCCs, whereas extreme nuclear pleomorphism or sarcomatoid and/or rhabdoid differentiation defined grade 4 tumors. It was agreed upon that chromophobe RCC should not be graded. There was consensus that microvascular invasion should not be included as a staging criterion for RCC.

AB - The International Society of Urological Pathology 2012 Consensus Conference made recommendations regarding classification, prognostic factors, staging, and immunohistochemical and molecular assessment of adult renal tumors. Issues relating to prognostic factors were coordinated by a workgroup who identified tumor morphotype, sarcomatoid/rhabdoid differentiation, tumor necrosis, grading, and microvascular invasion as potential prognostic parameters. There was consensus that the main morphotypes of renal cell carcinoma (RCC) were of prognostic significance, that subtyping of papillary RCC (types 1 and 2) provided additional prognostic information, and that clear cell tubulopapillary RCC was associated with a more favorable outcome. For tumors showing sarcomatoid or rhabdoid differentiation, there was consensus that a minimum proportion of tumor was not required for diagnostic purposes. It was also agreed upon that the underlying subtype of carcinoma should be reported. For sarcomatoid carcinoma, it was further agreed upon that if the underlying carcinoma subtype was absent the tumor should be classified as a grade 4 unclassified carcinoma with a sarcomatoid component. Tumor necrosis was considered to have prognostic significance, with assessment based on macroscopic and microscopic examination of the tumor. It was recommended that for clear cell RCC the amount of necrosis should be quantified. There was consensus that nucleolar prominence defined grades 1 to 3 of clear cell and papillary RCCs, whereas extreme nuclear pleomorphism or sarcomatoid and/or rhabdoid differentiation defined grade 4 tumors. It was agreed upon that chromophobe RCC should not be graded. There was consensus that microvascular invasion should not be included as a staging criterion for RCC.

KW - Grade

KW - International Society of Urological Pathology

KW - Kidney

KW - Microvascular invasion

KW - Necrosis

KW - Pathology

KW - Renal cell carcinoma

KW - Rhabdoid differentiation

KW - Sarcomatoid differentiation

KW - Tumor morphotype

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DO - 10.1097/PAS.0b013e318299f0fb

M3 - Article

VL - 37

SP - 1490

EP - 1504

JO - American Journal of Surgical Pathology

JF - American Journal of Surgical Pathology

SN - 0147-5185

IS - 10

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