(Lynch Syndrome patients) Clinical and prognostic factors for renal parenchymal, pelvis, and ureter cancers in SEER registries: Collaborative stage data collection system, version 2 - Altekruse - 2014 - Cancer - Wiley Online Library

 Note: not specific to genetics (eg. Lynch Syndrome)

SEER registries: Collaborative stage data collection system, version 2 (open access)

Renal pelvis and ureter

Kidney and renal pelvis cancers often are combined for the purposes of cancer surveillance, with ureter cancer presented separately. Renal pelvis and ureter cancers share CSv2 SSFs, however, and are grouped in the AJCC stage coding schema; cancers of the renal parenchyma have a different set of SSFs.[3] Findings for both renal pelvis and ureter cancers are presented in this report.

The SSFs for these cancer sites are World Health Organization or International Society of Urological Pathology (WHO/ISUP) grade[31] (SSF1) and depth of renal parenchymal invasion (SSF2).[32] Both SSFs for these sites affect prognosis. SSF1 for renal pelvis and ureter is the WHO/ISUP grade, a 2-grade system (low and high grade). This grading system was proposed by ISUP in 1998 and adopted by WHO in 2004 to better classify the tumor grade for urothelial carcinomas of the renal pelvis, ureter, bladder, and urethra.[33, 34] The strengths of the WHO/ISUP grade's clear-cut criteria and the elimination of subjective and arbitrary interpretation have greatly improved the ambiguous language that marked the 1973 WHO system.[35] SSF2, depth of renal parenchymal invasion, records the depth of tumor invasion into the renal parenchyma in millimeters as documented in the pathology report.

 With respect to renal pelvis and ureter cancer, a high WHO/ISUP grade (SSF1) is independently associated with worse outcomes in surgical cases.[42] WHO/ISUP grade was known for 85% of cases with resection. SSF2 (depth of renal parenchymal invasion as a marker of recurrence) also has been validated[43]; however, most values for this variable were unknown. Additional SSFs for renal pelvis and ureter cancer might be considered based on prognostic value. Promising markers for these understudied cancers include tumor architecture,[44, 45] multifocality,[46] and the presence of concomitant carcinoma in situ.[47] In some studies,[48] tumor location (ie, ureter, renal pelvis, or both) has also been suggested to have prognostic value.

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