CYTOGENETIC, HISTOPATHOLOGIC, AND IMMUNOLOGICAL STUDIES OF MULTIFOCALRENAL-CELL CARCINOMA

BACKGROUND. Multifocal tumor areas occurred in 12-22% of patients with renal cell carcinoma. It is unknown whether these tumors have maligna nt potential and characterize a higher risk for metastases. The perfor mance of nephron-sparing surgery in patients with low grade or low sta ge tumors is controversial. METHODS. Primary and secondary tumors were analyzed by conventional cytogenetics and fluorescence in situ hybrid ization. Production of interleukin (IL)-6, IL-10, IL-11, and transform ing growth factor (TGF)-beta 1 were determined using standard enzyme-l inked immunosorbent assay and bioassays. RESULTS. In 15.2% of the rena l cell carcinoma cases evaluated, multifocal tumors were detected. Cyt ogenetics revealed a concordance of primary and secondary tumors in 9 of 14 cases (64%). In 11 of 12 multifocal tumors (94%), the same immun ologic activity status was observed in both primary and secondary tumo rs.CONCLUSIONS. Secondary tumors must be expected to have malignant po tential similar to that of the primary turners. This was underscored b y the high concordance of cytogenetic, histopathologic, and immunologi c data in this study. (C) 1997 American Cancer Society.