How does the renal sinus involvement in renal cell carcinoma affect the prognosis?

Abstract

In the 2002 TNM/AJCC formulation, sinus involvement was recognized for the first time as an anatomic site of perirenal invasion. Thus, as you can imagine, there has been hardly any quality study addressing the importance of sinus invasion on the prognosis. Sinus invasion can take place in two ways. The first is direct extension of a renal tumor located primarily in the column of Bertin; and the second is extravascular extension of tumor thrombus in small veins coming off the renal parenchyma and subsequent extravascular extension into the sinus fat. A comprehensive study reported recently by the Mayo Clinic group indicates that the presence of extrarenal extension (perinephric fat invasion including renal sinus invasion), compared with its absence, is twice as likely to result in patients’ death from renal cell carcinoma.