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 J. Grignon, Rodolfo Montironi, John R. Srigley, Anila Abraham, Adebowale Adeniran, Khalid Ahmed, Hikmat Al Ahmadie, Robert Allan, Mahul Amin, Pedram Argani, Ulrika AxcronaMarc 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

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

All Science Journal Classification (ASJC) codes

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine

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    Delahunt, B., Cheville, J. C., Martignoni, G., Humphrey, P. A., Magi-Galluzzi, C., McKenney, J., Egevad, L., Algaba, F., Moch, H., Grignon, D. J., Montironi, R., Srigley, J. R., Abraham, A., Adeniran, A., Ahmed, K., Al Ahmadie, H., Allan, R., Amin, M., Argani, P., ... 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