Confused about Pathology report

gingersnaps

sblairc said:

Grade in chromophobe may not matter.

Just as an FYI. I've heard (think I read here) that with Chromophobe a "Grade" is really not a clinical indicator of aggressiveness. Not getting a "Grade" would be logical since it may not be significant FOR CHROMOPHOBE RCC. Other RCC's, it's important. If anyone has anything to add or to this comment, please do so. 

grade

I know but some places do still grade chromophobe using the furman system. We went to Cleveland clinic and they still used the old grading.

JennyDra

Grading

Yes..the pathology report says grade 2 on the fuhrman grading system. I have read that grade one is very rare. any views on grade 2???

gingersnaps

JennyDra said:

Grading

Yes..the pathology report says grade 2 on the fuhrman grading system. I have read that grade one is very rare. any views on grade 2???

grade

From everything I can read grade is of not significant in chromophobe. There is a different grading system. I was just interested in how many still use Fuhrman. I've read most are a grade 3 on Fuhrman scale.

Jmat23

JennyDra said:

Jmat....

As far as I have read It says that it is chromophobe.  It also says that the fatty tissue inside the kidney was unaffected.  I am just a bit worried of possible reoccurrence. We will eventually go too the oncologist but I have been really sick with a cold and the weather hasn't been great either. Thanks for the info.

You're welcome

You're welcome Jenny. Chromophobe rcc is rarer than clear cell rcc (5% of cases) and as I have clear cell most of the info I have is based on that type. Some studies say chromophobe has a better prognosis than clear cell and others say it is broadly similar. The smaller sample size due to the relative rarity of chromophobe rcc may lead to the confusion bearing in mind population stats don't really apply to individuals. I'm assuming for rarer types the population statiatics Are even less meaningful. I obviously can't say with any certainty but at grade 2 and a relatively small size, I'd say the prognosis would be very good. The fact they are offering a partial nephrectomy as an option says to me the risk of local recurrance is minimal which to me infers a good prognosis. The oncologist is the expert and I'm sure they will provide all the info you need.

sblairc

gingersnaps said:

grade

From everything I can read grade is of not significant in chromophobe. There is a different grading system. I was just interested in how many still use Fuhrman. I've read most are a grade 3 on Fuhrman scale.

This is interesting to me. I wonder how they determine agressive

I'm wondering if grade is not signficant, how they determine aggressiveness of the tumor in chromophobe. Does anyone know? 

Also, regarding chromophobe being "indolent" or "less aggressive" than clear cell RCC: My husbands oncologist told him that was an outdated theory and that it just tends to be found early in it's clinical stage because they tend to be larger tumors than clear cell. But then I've heard an expert in RCC say different at a conference, so it would seem there is some differing of opinion. 

Jmat23

sblairc said:

This is interesting to me. I wonder how they determine agressive

I'm wondering if grade is not signficant, how they determine aggressiveness of the tumor in chromophobe. Does anyone know? 

Also, regarding chromophobe being "indolent" or "less aggressive" than clear cell RCC: My husbands oncologist told him that was an outdated theory and that it just tends to be found early in it's clinical stage because they tend to be larger tumors than clear cell. But then I've heard an expert in RCC say different at a conference, so it would seem there is some differing of opinion. 

Grading

There is a 3 tier Chromophobe Grading system which I believe they use as opposed to the Furhman grading system. It seems Chromophobe grade 1&2 have similar outcomes with grade 3 being more aggresive as it can relate to Sarcomatoid change in the tumour and hence a greater propensity to spread. Take this with a grain of salt as I could be wrong! I'm not sure what other prognostic factors that might apply to chromophobe rcc - the only one I am aware of is tumour necrosis.